Surgical Technology_Principles and Practice 7th Edition Joanna Kotcher Fuller_TEST BANK

TEST BANK Surgical Technology: Principles and Practice 7th Edition Joanna Kotcher Fuller

TABLE OF CONTENTS Chapter 01: The Surgical Technologist Chapter 02: Communication and Teamwork Chapter 03: Law, Documentation, and Professional Ethics Chapter 04: The Health Care Facility Chapter 05: The Patient Chapter 06: Diagnostic and Assessment Procedures Chapter 07: Environmental Hazards Chapter 08: Microbes and the Process of Infection Chapter 09: The Principles and Practice of Aseptic Technique Chapter 10: Decontamination, Sterilization, and Disinfection Chapter 11: Surgical Instruments Chapter 12: Perioperative Pharmacology Chapter 13: Anesthesia and Physiological Monitoring Chapter 14: Postanesthesia Recovery Chapter 15: Death and Dying

Chapter 16: Physics and Information Technology Chapter 17: Energy Sources in Surgery Chapter 18: Moving, Handling, and Positioning the Surgical Patient Chapter 19: Surgical Skin Preparation and Draping Chapter 20: Case Planning and Intraoperative Procedures Chapter 21: Management of the Surgical Wound Chapter 22: Minimally Invasive Endoscopic and RoboticAssisted Surgery Chapter 23: General Surgery Chapter 24: Gynecological and Obstetrical Surgery Chapter 25: Genitourinary Surgery Chapter 26: Ophthalmic Surgery Chapter 27: Surgery of the Ear, Nose, Pharynx, and Larynx Chapter 28: Oral and Maxillofacial Surgery Chapter 29: Plastic and Reconstructive Surgery Chapter 30: Orthopedic Surgery Chapter 31: Peripheral Vascular Surgery Chapter 32: Thoracic and Pulmonary Surgery Chapter 33: Cardiac Surgery Chapter 34: Pediatric Surgery

Chapter 35: Neurosurgery Chapter 36: Emergency Trauma Surgery Chapter 37: Disaster Preparedness and Response

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Surgical Technology 7th Edition Fuller Test Bank Chapter 01: The Surgical Technologist Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The professional association for surgical technologists is the . a. Association of periOperative Registered Nurses b. American College of Surgeons c. Association of Surgical Technologists d. Accreditation Review Committee on Education in Surgical Technology ANS: C The AST is the surgical technologists’ professional organization. The association promotes professional standards by providing services to its members as well as legislative support to promote and formalize the status of surgical technologists.

DIF: 2.

1

REF: p. 3

demonstrates that a surgical technologist from an accredited program has achieved a minimum level of knowledge and skills. a. Licensure b. An associate’s degree c. Graduation d. Certification ANS: D Certification is a demonstration of competency to a particular standard, usually set by the professional organization.

DIF:

1

REF: p. 4

3. Certification for the surgical technologist is a. mandatory b. voluntary c. unnecessary d. invalid

.

ANS: B Certification is mandatory in some states for an individual to work in the profession.

However, in most states certification is voluntary. Note: All graduates from a CAAHEP-accredited program are required to take the CST examination before graduation.

DIF:

1

REF: p. 4

4. Certification differs from licensure in that certification . a. does not require continuing education credits b. allows employers to evaluate prospective employees by one verifiable national standard c. is not currently mandatory to practice in all 50 states

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d. is a no-cost examination ANS: C Licensure is a process in which the state government issues registration and the right to practice. Certification is mandatory in some states for an individual to work in the profession. This requirement is the national trend because it provides a demonstrable standard of knowledge. At the time of this writing, mandatory graduation from an accredited surgical technology program and certification is required in the states of Idaho, Indiana, Massachusetts, New Jersey, New York, South Carolina, Tennessee, and Texas. Two other states—Colorado and Washington—require formal registration of the individual’s legal name and place of residence.

DIF:

1

REF: p. 4

5. The profession of surgical technologist is defined today as a result of a. less demanding professional needs b. rapid monumental developments in technology in general c. growing demands in the ancillary departments d. advances in digital technology ANS: B Rapid monumental developments in technology help define the role of the surgical technologist.

DIF:

1

REF: p. 2

6. The need for assistive persoNnneRl inIsurG geryBd.idCnoM t arise until a. World War I b. Korean War c. Civil War d. World War II

.

ANS: D The need for assistive personnel in surgery did not arise until World War II. DIF:

1

7. During World War I, wounded. a. nurses b. assistants c. Corpsmen d. orderlies

REF: p. 2 worked on the battlefield to offer aid and comfort to the

ANS: C During World War I, Corpsmen worked on the battlefield to offer aid and comfort to the wounded.

DIF:

1

REF: p. 2

8. A new profession was born in the Army for the Corpsman; it was named

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.

a. b. c. d.

Corpsman I nurse CST ORT

ANS: D ORT, operating room technician, was a new profession born in the Army for the Corpsman.

DIF:

1

REF: p. 2

9. Registered nurses continued to fill the role of the scrub, or “instrument,” nurse until about . a. 1970 b. 1965 c. 1966 d. none of the above ANS: B RNs continued to fill the role of the scrub, or instrument, nurse until 1965.

DIF:

1

REF: p. 2

10. The Association of periOperative Registered Nurses (AORN) published a book called . a. The Role of the Operating Room Technician b. Teaching in the Operating Room c. Teaching the OperatingNRoR om I TecG hnicBia.nC M UpeS d. Surgical Techniques for O ratinNg RToom TeOchnician ANS: C The Association of periOperative Registered Nurses (AORN) published a book called Teaching the Operating Room Technician.

DIF:

1

REF: p. 2

11. In the AORN board of directors created the a. 1968, Association of Operating Room Technicians b. 1965, Association of Operating Room Technicians c. 1968, Association of Operating Room Nurses d. 1967, Association of Operating Room Nurses

.

ANS: C In 1968, the AORN board of directors created the Association of Operating Room Nurses.

DIF:

1

REF: p. 2

12. AORT stands for . a. Association of Operating Radiology Technician b. Association of Ophthalmic Register Technician c. Association of Operating Respiratory Technician d. Association of Operating Room Technicians

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ANS: D AORT stands for Association of Operating Room Technicians.

DIF:

1

REF: p. 2

13. In an effort to formalize technologists’ education, AORT created two new committees, which are the Joint Review Committee and the . a. AST b. LCC-ST c. CST d. CORT-ST ANS: B In an effort to formalize technologists’ education, AORT created two new committees, the Joint Review Committee and the Liaison Council on Certification for the Surgical Technologist (LCC-ST).

DIF:

1

REF: p. 2-3

14. The surgical technologist’s professional organization that supports students and graduates is . a. LCC b. CST c. AST d. NBSTSA ANS: C The surgical technologist’s professional organization that supports students and graduates is the Association of Surgical Technologists (AST).

DIF:

1

REF: p. 3

15. At the national level, AST provides the following support to students and graduates of surgical technologist and teaching institutions and the public . a. maintains practice standards, code of ethics, and code of conduct for the surgical technologist b. publishes a professional journal, The Surgical Technologist c. holds annual conferences for surgical technologists and educators d. all of the above ANS: D At the national level, AST provides the following support to students and graduates of surgical technologist and teaching institutions and the public: maintains practice standards, code of ethics, and code of conduct for the surgical technologist; publishes a professional journal, The Surgical Technologist; and holds annual conferences for surgical technologists and educators.

DIF:

1

REF: p. 3

16. It is important for students to become active members of AST to promote

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.

a. b. c. d.

standards of the profession the Association of Surgical Technology the Accrediting Review Council on Education in Surgical Technology themselves

ANS: A It is important for surgical technology students to become active members of the AST to promote the standards of the profession.

DIF:

1

REF: p. 3

17. As a body of professionals, surgical technologists are supported by a number of key organizations and partners. Each has a designated role in . a. certification, standards, continuing education, and promotion b. continuing education, promotion, standards, and accreditation c. standards, continuing education, accreditation, and promotion d. promotion, certification, accreditation, and continuing education ANS: D As a body of professionals, surgical technologists are supported by a number of key organizations and partners. Each has a designated role in promotion, certification, accreditation, and continuing education.

DIF:

1

REF: p. 3

18. The Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA) provides educational recommendations and required N R I G B.C M U S N T O for accreditation of programs in surgical technology and surgical first assisting. a. guidelines b. rules c. standards d. grades ANS: C The Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA) provides educational standards and recommendations required for accreditation of programs in surgical technology and surgical first assisting.

DIF:

1

REF: p. 3

19. Which of the following organizations oversees certification and credentialing for the surgical technologist? a. AORN b. AST c. NBSTSA d. CAAHEP ANS: C The National Board of Surgical Technology and Surgical Assisting (NBSTSA) oversees certification and credentialing of surgical technologists and surgical assistants.

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DIF:

1

REF: p. 3

20. Accreditation is granted to a school only after a. review of curriculum b. full on-site visit c. council review at the end of the year d. curriculum is submitted

.

ANS: B Accreditation is granted to a school only after a full on-site evaluation of the program and its facilities to ensure compliance with ARC/STSA standards.

DIF:

1

REF: p. 3

21. Surgical technologists are trained in a. 2-year colleges b. military c. proprietary certificate programs d. all the above

.

ANS: D Surgical technologists are trained in 2-year colleges, the military, and proprietary certificate programs.

DIF:

1

REF: p. 4

22. The Accrediting Bureau ofN HeaRlth I EduGcatiB on.Scho C Mols (ABHES) is another U S N T O accrediting body. a. for-profit b. nonprofit c. semiprofit d. none of the above ANS: B ABHES is another nonprofit accrediting body.

DIF:

1

REF: p. 3

23. Certification through the Association of Surgical Technologists requires _ a. graduation from an ABHES-accredited school b. graduation from an Armed Forces program c. graduation from a CAAHEP-accredited school d. all of the above

.

ANS: D Certification through the Association of Surgical Technologists requires graduation from an CAAHEP-accredited school, ABHES-accredited school, and federally sponsored Armed Forces program.

DIF:

1

REF: p. 3

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24. Certification demonstrates . a. standard of knowledge b. advanced level competencies c. understanding of the principles and practices of surgery d. support for NBSTSA ANS: A Certification demonstrates a standard of knowledge and understanding of the principles of surgical technology.

DIF:

1

REF: p. 4

25. To be eligible to take the certification examination, the applicant must meet all requirements EXCEPT . a. be a graduate of an accredited program (ABHES and CAAHEP) b. currently be a CST c. be a graduate of a military program d. have 7 of the last 10 years documented scrub experience ANS: D Individuals must be a graduate of an accredited program (CAAHEP and ABHES), currently a CST, and a graduate of a military program.

DIF:

1

REF: p. 4

26. The National Center for Competency Test requires applicants to have the following . a. b. c. d.

high school diploma or GED be a graduate of a formal operating room technician (ORT) training program A and B none of the above

ANS: C NCCT applicants must have a high school diploma or GED, be a graduate of an ORT training program, and have 7 years of validated scrub experience within the past 10 years.

DIF:

1

REF: p. 4

27. Suzie has taken the CST examination and passed. For Suzie to keep her certification without retaking the examination, she must do one of the following . a. attend the national conference b. maintain continuing education (CE) credits c. nothing d. attend all state meetings ANS: B CE credits provide an opportunity for professionals to improve their knowledge and competency.

DIF:

1

REF: p. 4-5

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28. The stated goals of a career ladder are primarily to do all the following EXCEPT . a. improve patient care b. promote accountability c. encourage employer recognition of the surgical technologist d. encourage experienced surgical technologists to contribute to the professional growth of their own career ANS: D The stated goals of a career ladder are primarily to improve patient care, encourage employer recognition of the surgical technologist, promote accountability, increase the visibility of the surgical technologist’s role in the health care facility, and encourage experienced surgical technologists to contribute to the professional growth of others.

DIF:

1

REF: p. 5

29. The nonsterile member of the surgical team is called a. assistant b. scrub c. circulator d. surgeon

.

ANS: C The circulator is a nonsterile team member.

DIF:

1

REF: p. 6

N R I G B.C M

30. The surgical technologist whU o wS orksNin T a hospitO al or other facility that provides 24-hour care is usually required to . a. take a break every hour b. be on “call” c. do nothing d. none of the above ANS: B The surgical technologist who works in a hospital or other facility that provides 24-hour care is usually required to be on “call.”

DIF:

1

REF: p. 6

31. The larger picture casts the surgical technologist’s role as a combination of four main areas of health care and technology EXCEPT . a. educator and preceptor b. participant in leadership and management c. patient care provider in the perioperative setting d. specialist in sterilization ANS: D

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The larger picture casts the surgical technologist’s role as a combination of four main areas of health care and technology: assistant in surgical procedures as part of the surgical team; specialist in the preparation, handling, and use of surgical devices, equipment, and instruments; patient care provider in the perioperative setting; participant in leadership and management, and educator and preceptor.

DIF:

1

REF: p. 7

32. James is a new graduate, and he is looking for a job in surgical technology. Career services has met with him and had him fill out applications for the following jobs. Of the following job fields, which one does James NOT qualify for as a new graduate? a. CST b. Central processing manager c. VA hospital, ST position d. Educator ANS: D Public trust means that patients, their families, and others in the care environment maintain a high level of confidence in the professionals who care for them. Entry-level certification and at least 2 years of experience in surgery are the minimum requirements for an educator position.

DIF: 33.

1

REF: p. 8

has particular attributes, attitude, and behavior that reflect a high standard of accountability, ethics, honesty, and respect for people. a. Someone highly trainedNU RS INGTB.COM b. Someone who uses his or her skills c. A professional d. Surgical technologist ANS: C Professionals have particular attributes, attitude, and behavior that reflect a high standard of accountability, ethics, honesty, and respect for people.

DIF:

1

REF: p. 9

MATCHING Match each item with the correct acronym. a. NBSTSA b. ABHES c. ARC/STSA d. CAAHEP e. AORN f. AST g. ORT h. CFA i. ACS

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j. RN k. CST l. NCCT m. STCR n. LPN 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

Surgical Technologist Circulating Role Operating Room Technician National Board of Surgical Technology and Surgical Assisting Association of Operative Registered Nurses Licensed practical nurse Accrediting Bureau of Health Education Schools Registered nurse Association of Surgical Technologists Commission on Accreditation of Allied Health Education Programs American College of Surgeons Certified surgical technologist Accreditation Review Council on Education in Surgical Technology and Surgical Assisting Certified first assistant National Center for Competency Testing

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS:

M G A E N B J F D I K C H L

DIF: 2 REF: p. 6 DIF: 2 REF: p. 2 DIF: 2 REF: p. 3 DIF: 2 REF: p. 2 N R I G B. DIF: U2 S N T RC EO F:M p. 4 DIF: 2 REF: p. 3 DIF: 2 REF: p. 4 DIF: 2 REF: p. 3 DIF: 2 REF: p. 3 DIF: 2 REF: p. 4 DIF: 2 REF: p. 3 DIF: 2 REF: p. 3 DIF: 2 REF: p. 8 DIF: 2 REF: p. 4

Match the definition with the role of the surgical technologist. You may use the same answer more than once. a. Scrub role b. Circulator c. Second assistant d. Preceptor e. Instrumentation specialist f. Leadership and management 15. Maintain retraction of tissue 16. Communicate effectively with surgeon to prevent errors, such as passing the wrong instrument or passing it in the wrong position

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17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

Nonsterile team member who assists the RN Assist with hemostasis as directed by the surgeon Specialist in the preparation, handling, and use of instruments Irrigating the surgical wound, especially in microsurgery Teaching others while scrubbed Pursue an advanced degree in hospital administration and management Skills and knowledge required for this role are the processes of sterilization and disinfection, inspection of and troubleshooting equipment, and assembly of instrument tray Maintain a “dry” surgical site by operating suction devices and appropriate use of surgical sponge Ensure patient chart, including results of diagnostic procedures, permits, and preoperative checklist, accompanies the patient into surgery Prepares instruments and supplies on the sterile field Role is fulfilled by a registered nurse A teacher The nonsterile person who performs patient care procedures, obtains and delivers the equipment needed for a surgery case, opens sterile supplies, and assists in positioning the patient on the operating table Facilitating safety and emergency protocols Assist surgeon in specific, well-defined task as needed during the procedure

15. ANS: 16. ANS: 17. ANS: 18. ANS: 19. ANS: 20. ANS: 21. ANS: 22. ANS: 23. ANS: 24. ANS: 25. ANS: 26. ANS: 27. ANS: 28. ANS: 29. ANS: 30. ANS: 31. ANS:

C A B C E C D F E C B A B D B F A

DIF: 2 REF: p. 6 DIF: 2 REF: p. 5 DIF: 2 REF: p. 6 DIF:N 2R I G B.RC EF:M p. 6 U S N T REF: O p. 6 DIF: 2 DIF: 2 REF: p. 7 DIF: 2 REF: p. 6 DIF: 2 REF: p. 7 DIF: 2 REF: p. 7 DIF: 2 REF: p. 7 DIF: 2 REF: p. 6 DIF: 2 REF: p. 6 DIF: 2 REF: p. 6 DIF: 2 REF: p. 6 DIF: 2 REF: p. 7 DIF: 2 REF: p. 6 DIF: 3 REF: p. 7

Match the following definitions with the correct term. a. Facility-based ST b. Military service c. Specialty practice d. CST-CFA e. Educator and clinical instructor f. Medical industry representative g. Central processing management

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h. Research product and development 32. Work in research product and development in the area of surgical instruments, supplies, and devices 33. Designs and develops the curriculum for the institution and manages departments 34. Assists in surgical procedures to retract tissue and aid in exposure, hemostasis, close tissue planes, and other intraoperative techniques while under supervision of the surgeon 35. Education program parallels civilian requirements, with additional training in combat and war surgery and in golden hour treatment 36. The scope of duties and responsibilities includes disinfection and sterilization processes, assembly of surgical instrument sets, and management of complex instrument systems 37. Promote the company’s equipment but also has the technical expertise to troubleshoot problems 38. The hospital-based surgical technologist may specialize in one or more surgical specialties such as orthopedics, neurosurgery, cardiac surgery, obstetrics, or plastic surgery 32.

33.

34.

35.

36.

37.

38.

ANS: ANS: ANS: ANS: ANS: ANS: ANS:

H E D B G F C

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF:

p. 6 p. 8 p. 8 p. 8 p. 7 p. 8 p. 8

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Chapter 02: Communication and Teamwork Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. a. b. c. d.

and are two of the most important components of patient care.

Teamwork and professionalism Communication and professionalism Communication and teamwork Teamwork and skills

ANS: C Communication and teamwork are two of the most important components of patient care.

DIF:

1

REF: p. 10

2. Surgery is performed by a. surgeons b. nurses c. surgical technologists d. teams of health professionals

.

ANS: D Surgery is performed by teams of health professionals.

DIF: 3.

1

G B.C M U S N T O

REFN : pR . 10I

is a quality found in people with self-esteem. This type of behavior seeks to protect one’s own rights while respecting those of others. a. Aggressiveness b. Offensiveness c. Assertiveness d. Emotion ANS: C Assertiveness is defined as a quality in people with self-esteem; assertive behavior seeks to protect one’s own rights while respecting those of others.

DIF:

4. a. b. c. d.

1

REF: p. 15

are behaviors that are accepted as part of the environment and culture of a group.

Norms Laws Regulations Rules

ANS: A Norms are defined as behaviors that are accepted as part of the environment and culture of a group. Norms are usually established by custom and popular acceptance rather than by law, although the two may not be mutually exclusive.

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DIF:

1

REF: p. 10

5. Communication is a two-way process between the a. ST and patient b. sender and receiver c. surgeon and circulator d. accuser and accused

.

ANS: B Communication is a two-way process in which one person (the sender) expresses ideas and feelings and another (the receiver) receives them, processes them, and gives feedback.

DIF: 6. a. b. c. d.

1

REF: p. 11

is the expression of emotion or opinion contained in the delivery of a message.

Expression Body language Sensitivity Tone

ANS: D Tone is the environment of the message. It reflects the sender’s emotions, such as respect for the receiver, opinion about the message, or attitude toward the receiver.

DIF:

1

REF: p. 12

N R I G B.C M

7. a. b. c. d.

is the response to aUmeSssaN ge aT nd is a O component of effective communication.

Feedback Aggression Harassment Abuse

ANS: A Feedback is a response by the receiver that acknowledges the message that was sent.

DIF:

1

REF: p. 16

8. The most important reason to increase among coworkers and management. a. staff b. salaries c. communication skills d. gossip and rumors

is to maintain respect, trust, and empathy

ANS: C Among the most important reasons to improve communication skills is to maintain respect, trust, and empathy among coworkers and management. The operating room environment is often rushed, tense, and even brusque.

DIF:

1

REF: p. 11

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9. Poor patient care, errors, conflict, and stress are results of a. poor communication skills b. aggression c. lack of educated team members d. cultural differences

.

ANS: A Good communication greatly increases the safety of the environment for the patient. Poor communication results in poor patient care, errors, conflict, and stress.

DIF:

1

REF: p. 11

10. Many health care workers are surprised to find that the greatest challenge in their work is not the work itself but the of the workplace. a. stress b. acceptable social distance c. gender value d. interactions and social climate ANS: D Even under the best circumstances, communication can be difficult. Many health care workers are surprised to find that the greatest challenge in their work is not the work itself but the interactions and social climate of the workplace.

DIF:

1

REF: p. 11

N R I G B.C M

11. Even if the sender does not wUishS to eN xprT ess his oOr her true feelings about the message, these feelings will probably be conveyed by . a. aggressive behavior b. assertiveness c. body language d. gossip or rumors ANS: C The way we use posture, gestures, and expressions to convey ideas and messages is called body language. These cues can emphasize the message or convey a meaning that differs significantly from what was originally intended.

DIF: 12. a. b. c. d.

1

REF: p. 12

can be both an expression of comfort and a way of controlling people.

Harassment Touch Values Interactions

ANS: B Touch can be both an expression of comfort and a way of controlling people. Touch, except in social gestures such as hand-shaking, is almost never neutral.

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DIF:

1

REF: p. 13

13. Good communication clarifies relationships and helps establish professional and social boundaries. It increases teamwork and goals, which will greatly increase the safety of the environment for the . a. surgeon b. management staff c. ancillary departments d. patient ANS: D Good communication clarifies relationships and helps to establish professional and social boundaries. It increases teamwork and reinforces team goals. Good communication greatly increases the safety of the environment for the patient.

DIF:

1

REF: p. 11

14. The person with uses extreme defensive or aggressive tactics to achieve social comfort. a. problem behavior b. good communication skills c. the ability to be a team player d. respect for others ANS: A Problem behaviors cause mistrust, frustration, and interpersonal conflict. The person with problem behaviors uses extN remR e deIfenG siveBo. rC aggM ressive tactics to achieve a level of social U S N T O comfort.

DIF:

1

15.

REF: p. 19 is a response by the receiver acknowledging receipt of the message and

its content. a. Sender b. Receiver c. Feedback d. Message ANS: C Feedback is a response by the receiver acknowledging receipt of the message and its content.

DIF: 16.

1

REF: p. 16

is the manner or implied feelings behind the message, reflected in emphasis on certain words or pitch of the voice. a. Tone b. Pitch c. Attitude d. None of the above

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ANS: A Tone is the manner or implied feelings behind the message, reflected in emphasis on certain words or pitch of the voice.

DIF:

1

REF: p. 12

17.

is the way we use posture, gestures, and expressions to convey ideas or messages. a. Verbal communication b. Body language c. Neutral language d. All of the above ANS: B Body language is the way we use posture, gestures, and expressions to convey ideas or messages.

DIF:

1

18.

REF: p. 12 is purposeful touch that conveys empathy, tenderness, and care.

a. b. c. d.

Medical touch Positive touch Engaging touch Therapeutic touch

ANS: D Therapeutic touch is purpoN sefuR l touch I GthatBc.onCveyMs empathy, tenderness, and care.

U S N T

DIF: 19.

1

O

REF: p. 13

is a set of guidelines to help people use email and other types of Internet communication in a way that promotes personal security, respect, and clarity. a. Email guidelines b. Work email guidelines c. Workplace communication d. Netiquette ANS: D Netiquette is a set of guidelines to help people use email and other types of Internet communication in a way that promotes personal security, respect, and clarity.

DIF:

20.

1

REF: p. 13

is/are a way for people to talk with others in their personal and professional community. a. Email b. Facebook c. Twitter d. Blogs ANS: D

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Blogs are a way for people to talk with others in their personal and professional community.

DIF: 21.

1

REF: p. 13

is the ability to communicate effectively with people of different cultures and subcultures within populations. a. Cultural competence b. Cultural reference c. Cultural guidelines d. Cultural difference ANS: A Cultural competence is the ability to communicate effectively with people of different cultures and subcultures within populations.

DIF:

1

REF: p. 14

22. Effective communication results when the delivery is appropriate to the a. situation b. environment c. emotion d. bias

.

ANS: A Effective communication results when the delivery is appropriate to the situation.

Communication should take place with the right person, at the right time, and in the right place.

DIF:

1

REF: p. 17

23. Which of the following is a characteristic between the health professional and the public? a. The public looks to the professional for aggression. b. The public looks to the professional for perceptions. c. The public looks to the professional for gossip and rumors. d. The public looks to the professional for reassurance.

ANS: D The public looks to the professional for reassurance.

DIF:

1

REF: p. 18

24. The respectful person does not a. practice active listening b. respond with empathy c. value the views and ideas of others d. disparage another person

.

ANS: D The respectful person does not disparage another person to appear to be smarter, more skilled, or “better.”

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DIF:

1

REF: p. 16

25. Despite changing social norms room. a. sexual abuse b. verbal abuse c. violence d. sexual harassment

is a significant problem in the operating

ANS: B Despite changing social norms verbal abuse is a significant problem in the operating room.

DIF:

1

REF: p. 19

26. Stressors in the operating room environment can block a. conflict resolution b. politeness c. good communication and teamwork d. conflicting priorities

.

ANS: C Stressors in the operating room can block good communication and teamwork.

DIF:

1

REF: p. 28

27. Which of the following causes of team conflict is an interpersonal conflict? a. Personality clash b. Role confusion c. Personal space d. Organizational skills ANS: A Personality clashes, attempts to gain control of the group, and power plays are some causes of team conflict.

DIF:

1

REF: p. 24

MATCHING Match the characteristics of good teamwork and team conflict with their most correct description. You may use the same answer more than once. a. Yielding b. Change c. Politeness d. Collaboration e. Conflict 1. Saying “please” or “thank you.”

2. Accepting the fact that others have valid points of view and conceding when one has made incorrect assumptions or conclusions.

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3.

4.

5.

6.

7.

8.

Working together for a common purpose.

The ability to adjust to unfolding events during a surgical procedure.

Poor communication and role confusion.

Speaking to others in a calm manner without sarcasm.

Cooperation and the ability to accept one another’s individual personalities.

A surgical technologist wants to show the student how much they know rather than allow the student to participate.

9. Identifying new tasks or procedures and implementing them with as little disruption as possible.

10. Open minded and retains a sense of fairness during team interaction.

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS:

C A D B E C D E B A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 23 p. 23 p. 23 p. 23 p. 24 p. 23 p. 23 p. 24 p. 23 p. 23

Match the following terms with their most correct description. a. Emotions b. Environmental barriersN R I G B.C M U S N T O c. Lack of a desire to communicate d. Perceptions e. Bias f. Lack of understanding g. Social and cultural influences 11. One person may perceive an unemotional patient as a “stoic,” strong, brave person facing illness. Another person may see the same patient as extremely anxious and fearful, speechless, and unable to express emotion because of the intensity of his or her emotions.

12. How we perceive a problem, situation, or action sometimes depends on our social and cultural background as much as our knowledge.

13. An effective communication stopper 14. How we feel at the time of communication 15. The receiver does not have sufficient knowledge to understand exactly what the sender is trying to communicate.

16. Hearing is a particular problem in the operating room.

17. To be successful in sending and receiving information, a person must want to communicate.

11. ANS: 12. ANS: 13. ANS: 14. ANS:

D G E A

DIF: DIF: DIF: DIF:

2 2 2 2

REF: REF: REF: REF:

p. 17 p. 17 p. 17 p. 17

SOURCE: Browsegrades.net

15. ANS: F 16. ANS: B 17. ANS: C

DIF: DIF: DIF:

2 2 2

REF: p. 17 REF: p. 17 REF: p. 17

Choose from the terms listed and match them with their most correct description. a. Remain calm b. Remind yourself of the facts c. Make an assertive statement d. Sidestep the behavior e. Do not become aggressive f. Stand up for your coworkers g. Challenge authorities who allow the abuse to continue h. If abuse becomes violent 18. If you cannot stop the behavior, wait until after surgery, then confront the abuser or report it in writing.

19. You must be prepared to address the abuser.

20. “Dr. X, it is not necessary to scream at me. When you do that, I can’t work.”

21. Seek justification for allowing abuse to continue and do not allow yourself to feel personal defeat in the face of administration’s complacency.

22. “I’ll get a replacement for that instrument right now.”

23. “I have the right not to take this abuse.”

24. Do not be afraid to request the presence of others who are in an administratively stronger position to stop the abuser.

25. If you are in a room where your coworker is being abused, defend the person.

18. ANS: 19. ANS: 20. ANS: 21. ANS: 22. ANS: 23. ANS: 24. ANS: 25. ANS:

E A C G D B H F

N R ING TB.COM

DIF: U1 S DIF: 1 DIF: 1 DIF: 1 DIF: 1 DIF: 1 DIF: 1 DIF: 1

REF: REF: REF: REF: REF: REF: REF: REF:

p. 20 p. 20 p. 20 p. 20 p. 20 p. 20 p. 20 p. 20

SOURCE: Browsegrades.net

Chapter 03: Law, Documentation, and Professional Ethics Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Health care professionals are guided in their practice by a. standards b. laws c. policies and regulations d. all of the above

.

ANS: D Health care professionals are guided in their practice by standards, laws, regulations, and policies.

DIF:

2

REF: p. 31

2. Law in most society is intended to protect a. government officials b. state officials c. individuals d. none of the above

.

ANS: C Law in most societies is intended to protect individuals from harm and promote a peaceful society.

DIF:

2

REF: p. 31

3. Professional standards are . a. specific requirements that help promote AST standards and guidelines b. specific requirements that help promote the operating room c. specific requirements that help promote surgical guidelines d. specific requirements that help promote and ensure safety and care ANS: D Professional standards are specific requirements that help promote and ensure safety and care.

DIF:

2

REF: p. 31

4. Ethics are . a. standards and guidelines b. values c. morals d. all of the above ANS: B Ethics are values that are highly regarded by individuals and society.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 31

5. The health care professions have these particular ethics related to beneficences a. accountability, honesty, morals, and values b. integrity, accountability, honesty, and values c. honesty, integrity, accountability, and trust d. trust, honesty, integrity, and morals ANS: C The health care professions have particular ethics related to beneficences: accountability, integrity, honesty, and trust.

DIF:

2

REF: p. 31

6. Law is a . a. guideline, set by our law enforcement b. rule or set of rules that law enforcement regulates c. rule or set of rules that governments make to regulate people’s behavior d. guideline set by government to regulate behavior ANS: C Law is a rule or set of rules that governments make to regulate people’s behavior.

DIF: 7. a. b. c. d.

2

REF: p. 31

is the transfer of responsibility for a task from one person to another.

Compensation Delegation Regulation Segregation

ANS: B Delegation is the transfer of responsibility for a task from one person to another. This is a frequent occurrence in all health care settings, especially where licensed personnel work directly with allied health professionals.

DIF:

2

REF: p. 32

8. A set of rules or regulations that hospital employees are required to follow, created to protect patients and employees from harm and to ensure the smooth operation of the hospital, is called . a. code of ethics b. operative consents c. hospital policy d. medical practice acts ANS: C The hospital policy manual describes general administrative and logistical operations of the hospital. It includes an organizational chart that clarifies the chain of command and information on other topics such as the rules about employee identification, privileges, and salary procedures.

SOURCE: Browsegrades.net

.

DIF:

2

REF: p. 32

9. Negligence committed by a professional who deliberately acts outside of her or his scope of practice, or while impaired, is known as _. a. damages b. malpractice c. a sentinel event d. complaints ANS: B Malpractice is negligence committed by a professional. Malpractice may also be committed if a person deliberately acts outside of his or her scope of practice or while impaired.

DIF:

2

REF: p. 34

10. The circulator has transported the patient to the operating room but has forgotten the patient’s chart. The circulator leaves the patient alone and returns to the preoperative area to get the chart. Upon returning, the circulator finds the patient lying on the floor. The circulator may be charged with . a. abandonment b. improper ethical choices c. sexual harassment d. forgetting the patient’s chart ANS: A Another situation of abandonment exists when one of the team members leaves the room for N dur RS I surg GTery.

B.C M an extended period before orU ing N AnOemergency can occur at any time and all team members must be present when the patient is in the room. Leaving a patient alone in a hallway or in the operating room suite constitutes abandonment.

DIF:

2

REF: p. 36

11. A derogatory statement concerning other coworkers’ skills, character, or reputation is unprofessional and known as a(n) . a. ethical dilemma b. tort c. sentinel event d. defamation ANS: D Defamation is a derogatory statement made by one person about another.

DIF:

2

REF: p. 37

12. Intentionally lying or falsifying information given during a court testimony after being sworn to tell the truth is known as . a. a tort b. perjury c. libel

SOURCE: Browsegrades.net

d. a complaint ANS: B When testifying, it is imperative to tell the truth because the practitioner is under oath. To lie under oath is called perjury, which is a punishable crime.

DIF:

2

REF: p. 35

13. A legal document stating the patient’s wishes for refusing or limiting care if the patient becomes incompetent is known as a(n) . a. nurse practice act b. advance directive c. living will d. code of ethics ANS: C A living will is a legal document that specifically states the type of medical intervention or treatment the patient wants. Possible interventions included are artificial feeding, transfusions, specific diagnostic tests, pulmonary maintenance on a ventilator, and the use of medications.

DIF:

2

REF: p. 45

14. A(n) is an unexpected occurrence involving death or serious psychological injury, or risk thereof. It is titled as such because it signals the need for immediate investigation and response. a. sentinel event b. medical practice act c. ethical dilemma d. recommended practice ANS: A Surgeries on a wrong level, wrong site, wrong side, and wrong patient are considered sentinel events.

DIF:

2

REF: p. 34

15. A wrong, independent of contract law violations, perpetrated by one person against another person or person’s property that can be compensable by money damages is known as . a. a tort b. slander c. damages d. negligence ANS: A A tort is a civil wrong—an act committed against a person or a person’s property.

DIF:

2

REF: p. 34

SOURCE: Browsegrades.net

16. Described as personal standards, personal conduct. a. policies and procedures b. morals c. laws d. ethics

are adopted by persons to govern their

ANS: B Morality or morals may be described as personal standards that are often influenced by culture, religion, and other traditions. Morality usually attempts to define what is “right” or “wrong” behavior.

DIF: 17. a. b. c. d.

2

REF: p. 46

are defined as rules that regulate the conduct of specific groups of people.

Societal standards Laws Ethics Guidelines

ANS: C Ethics refers to a standard of behavior created by specific groups of people to establish the conduct of their own members.

DIF:

2

REF: p. 31

18. Under the U.S. Constitution, each state has the power to regulate businesses and N R If me GTdicine B.CO M professions, including the praUcticSe oN and nursing. The laws differ from state to state and are called and . a. medical, surgical laws b. policies, procedures c. hospital policy, operating room policy d. medical practice acts, nurse practice acts ANS: D Under the U.S. Constitution, each state has the power to regulate the practice of medicine and professional nursing. The laws differ from state to state and are called medical practice acts and nurse practice acts. These laws require that a person obtain a license before practicing medicine or nursing.

DIF: 19.

2

REF: p. 31-32

are performed by two people during any surgery in which an item can be lost inside the patient. a. X-rays b. Extra precautions c. Negligent acts d. Surgical counts ANS: D

SOURCE: Browsegrades.net

The scrub and the circulator are responsible for the surgical counts; however, the physician is the one who actually places items inside the patient, so he or she may also be legally responsible for an item being left in the patient.

DIF:

2

REF: p. 35

20. Because of the legal implications of this document, it must be signed by the physician, the patient, and a witness. This document is called a(n) . Without this signed document, surgery cannot proceed. a. surgical count sheet b. informed consent c. advance directive d. operative record ANS: B A patient operative consent form or informed consent is a legal document that the patient must sign before surgery.

DIF:

2

REF: p. 40

21. The Health Insurance Portability and Accountability Act of 1996 (HIPAA), created by the U.S. Department of Health and Human Services (HHS), outlines federal standards for the protection of . a. criminal actions b. licensed personnel c. operating room personnel d. a patient’s privacy ANS: D The HIPAA of 1996, created by the Department of HHS, protects patients’ medical records and other health information through its privacy rule.

DIF: 22.

2

REF: p. 37

have the right to equal treatment, regardless of age, physical attributes, mental state, ethnicity, or socioeconomic status. a. Members of certain cultures and societies b. An employee’s family members c. All patients with medical insurance d. All patients ANS: D All patients have the right to equal treatment regardless of age, physical attributes, mental state, ethnicity, or socioeconomic status.

DIF:

2

REF: p. 46

23. Aeger primo is defined as a. death of a patient b. the patient first

.

SOURCE: Browsegrades.net

c. suspected malpractice d. first do no harm ANS: B The AST has adapted a Latin phrase to describe its ethos: aeger primo, which means “the patient first.”

DIF:

2

REF: p. 49

24. A mandated procedure for ensuring that surgery is performed on the correct patient, site, and side is called . a. timeout b. pause time c. recheck time d. time check ANS: A Perioperative nurses and other regulating agencies now require a “timeout” immediately before the start of the procedure or incision for a final verification of the surgical procedure and location of the proper surgical incision site.

DIF:

2

REF: p. 36

25. The operating room a. MSDS Manual b. AORN Guidelines c. Code of Ethics d. procedure manual

is distinct from the hospital policy.

ANS: D The operating room procedure manual is distinct from the hospital policy.

DIF:

2

26. Patient falls are the a. only b. last c. leading d. all the above

REF: p. 32 cause of death in hospitalized people over 65.

ANS: C Patient falls are the leading cause of death in hospitalized people over 65.

DIF:

2

REF: p. 35

27. Choose the correct statement concerning common circumstances in which falls occur. a. The side rails on a stretcher are not kept raised. b. Children are left unattended. c. Unsafe transfer techniques are used. d. All of the above.

SOURCE: Browsegrades.net

ANS: D The following are examples of common circumstances in which falls occur: The side rails on a stretcher are not kept raised. Children are left unattended. Unsafe transfer techniques are used.

DIF:

2

REF: p. 35

28. The universal protocol or is a verification procedure in which the team pauses just before surgery and begins to acknowledge essential information about the operative site and side, patient identity, position, and other crucial information about the patient and procedure. a. standards b. timeout c. guidelines d. viewed ANS: B The universal protocol or timeout is a verification procedure in which the team pauses just before surgery and begins to acknowledge essential information about the operative site and side, patient identity, position, and other crucial information about the patient and procedure.

DIF:

2

REF: p. 36

29. Any tissue or foreign object removed from the patient during surgery requires careful handling and . a. information b. diagnosis c. evidence d. documentation ANS: D Any tissue or foreign object removed from the patient during surgery requires careful handling and documentation.

DIF:

2

REF: p. 36

30. Surgical technologists are required to a. mix b. label c. prepare d. all of the above

medications on the field.

ANS: D Surgical technologists are required to label, mix, and prepare medications on the field.

DIF:

2

31.

REF: p. 36 errors are among the most prevalent and serious errors occurring during

surgery.

SOURCE: Browsegrades.net

a. b. c. d.

Labeling Instrumentation Sterilization Calculation

ANS: A Labeling errors are among the most prevalent and serious errors occurring during surgery.

DIF: 32.

2

REF: p. 36

is defined as neglecting a patient, or leaving a patient unattended when the patient requires the presence of a health care professional. a. Error b. Misleading c. Transferring d. Abandonment ANS: D Abandonment is defined as neglecting a patient, or leaving a patient unattended when the patient requires the presence of a health care professional.

DIF:

2

REF: p. 36

33. Failure to can occur when a member of the team neglects to pass on vital information that requires action. a. care b. communicate c. touch d. all of the above ANS: B Failure to communicate can occur when a member of the team neglects to pass on vital information that requires action.

DIF:

2

REF: p. 36

34. You are scrubbed with Dr. Jones on a laparoscopic cholecystectomy. Dr. Jones and Dr. Adams start telling jokes in a sexual manner. These comments make you feel uncomfortable; you would consider this . a. verbal abuse b. horizontal abuse c. sexual harassment d. all of the above ANS: C Sexual harassment is unwanted sexual coercion, lewd comments, innuendoes, or touching perpetrated by one person on another.

DIF:

2

REF: p. 37

SOURCE: Browsegrades.net

35. Tammy is a program director and is always talking about her supervisor. Tammy informs the class that her supervisor is uneducated and does not know the standards and guidelines.

Because Tammy has made this statement verbally this is considered . a. defamation b. negligent c. assault d. slander ANS: D If the actions are verbal, it is slander.

DIF:

2

36.

REF: p. 37 means deliberate efforts to erode the reputation of another person.

a. b. c. d.

Defamation Assault Battery Slander

ANS: A Defamation means deliberate efforts to erode the reputation of another person.

DIF:

2

REF: p. 37

37. Civil is the threat or attempt to harm another person. a. battery b. false imprisonment c. assault d. slander ANS: C Civil assault is the threat or attempt to harm another person.

DIF: 38. a. b. c. d.

2

REF: p. 37

involves contact with intent to injure and applies even if no injury occurred.

Battery False imprisonment Assault Slander

ANS: A Battery involves contact with intent to injure and applies even if no injury occurred.

DIF:

2

REF: p. 37

39. HIPAA protects patient’s privacy rule. a. personal belongings b. family c. medical records

and other health information through its

SOURCE: Browsegrades.net

d. treatment records ANS: C HIPAA protects patient’s medical records and other health information through its privacy rule.

DIF: 40.

2

REF: p. 37

is the means for making a permanent legal record of the patient’s interaction with health care providers and services. a. Medical records b. Treatment records c. Documentation d. Forms ANS: C Documentation is the means for making a permanent legal record of the patient’s interaction with health care providers and services.

DIF:

2

REF: p. 38

41. A patient’s operative consent form, or , is the process in which the attending practitioner explains risks, benefits, and alternatives of the surgery to the patient. a. health literacy b. signed consent c. informed consent d. anesthesia consent ANS: C A patient’s operative consent form, or informed consent, is the process in which the attending practitioner explains risks, benefits, and alternatives of the surgery to the patient.

DIF:

2

REF: p. 38

42. The surgical consent is signed by the a. nurse, surgeon, anesthesiologist b. surgeon, nurse, family member c. patient, surgeon, nurse d. patient, surgeon, witness

,

, and a(n)

.

ANS: D The surgical consent is signed by the surgeon, the patient, and a witness.

DIF:

2

REF: p. 40

43. A is a legal document that specifically states the type of medical intervention or treatment the patient wants. a. medical power of attorney b. living will c. DNR d. none of the above

SOURCE: Browsegrades.net

ANS: B A living will is a legal document that specifically states the type of medical intervention or treatment the patient wants.

DIF:

2

REF: p. 45

44. The surgical technologist has the right to abstain from participation in certain types of cases that violate his or her ethical, moral, or religious values. This is known as _ . a. ethical dilemmas b. refusal to perform an assigned task c. moral dilemma d. all of the above ANS: B The surgical technologist has the right to abstain from participation in certain types of cases that violate his or her ethical, moral, or religious values. This is known as refusal to perform an assigned task.

DIF:

2

REF: p. 47

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Statutes b. Administrative law 1. Laws that are passed by legislative bodies 2. Regulations passed by agencies and departments of the government 3. Rules established by the Environmental Protection Agency (EPA) for the handling of medical waste.

1. ANS: A 2. ANS: B 3. ANS: B

DIF: DIF: DIF:

3 3 3

REF: p. 47 REF: p. 31 REF: p. 31

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Intentional tort b. Unintentional tort c. Criminal liability 4.

5.

6.

7.

8.

9.

Injury as a result of improper positioning Invasion of privacy A derogatory statement made by one person about another Negligence Theft of hospital policy HIPAA violation

SOURCE: Browsegrades.net

10. Committed inadvertently, without intent to harm 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS:

B A A B C A B

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF:

p. 36-37 p. 37 p. 34 p. 34 p. 34 p. 34 p. 34

SOURCE: Browsegrades.net

Chapter 04: The Health Care Facility Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The surgical department is structured and engineered to provide a safe and efficient environment for patients and staff members. Many different designs can be used, but all must achieve the following objective(s). a. infection control b. environmental safety c. efficient use of personnel, time, space, and resources d. all of the above ANS: D The surgical department is structured and engineered to provide a safe and efficient environment for patients and staff members. Many different designs can be used, but all must achieve the following objectives: infection control, environmental safety, efficient use of personnel, time, space, and resources DIF: 2.

2

REF: p. 53

and areas (those with the greatest potential sources of infection) are physically separated when possible. a. Clean and contaminated b. Clean and dirty c. Clean and clean contamNinUaR teS d INGTB.COM d. None of the above ANS: A Clean and contaminated areas (those with the greatest potential sources of infection) are physically separated when possible.

DIF:

3.

2

REF: p. 53

engineering in the operating room (OR) follows national medical engineering standards for electrical circuits, inline gases, lighting, and other utilities. a. Mechanical b. Physical c. Environmental d. All of the above ANS: C Environmental engineering in the OR follows national medical engineering standards for electrical circuits, inline gases, lighting, and other utilities.

DIF:

1

REF: p. 53

4. All of the following are core principles of operating room design EXCEPT a. personnel policies

SOURCE: Browsegrades.net

.

b. infection control c. environmental safety d. efficiency ANS: A The surgical department is structured and engineered to provide a safe and efficient environment for patients and staff members. Many designs can be used, but all must achieve the following objectives: infection control, environmental safety, and efficient use of personnel, time, space, and material resources.

DIF: 5.

2

REF: p. 53

create(s) boundaries between areas that carry the highest potential sources of infection and those that are the cleanest. a. Airflow b. Traffic patterns c. Clean area d. Certain areas ANS: B Traffic patterns create boundaries between areas that carry the highest potential sources of infection and those that are the cleanest.

DIF:

6. a. b. c. d.

2

REF: p. 53

is the area where instruments and equipment are cleaned and disinfected.

Central core Restricted Storage Decontamination

ANS: D The decontamination area is where surgical instruments and equipment are disinfected after use.

DIF: 7. a. b. c. d.

2

REF: p. 53

is the primary accreditation organization for all health care facilities.

Occupational Safety and Health Administration The Joint Commission Association for Professionals in Agency for Healthcare Research and Quality None of the above

ANS: B The Joint Commission is the primary accreditation organization for all health care facilities.

DIF:

1

REF: p. 52

8. The clean utility room within the surgical department is a(n) a. restricted b. unrestricted

SOURCE: Browsegrades.net

area.

c. semi-restricted d. none of the above ANS: C The corridors between surgical rooms, the instrument and supply processing area, storage areas, and clean utility rooms within the surgical department are semi-restricted areas.

DIF:

2

REF: p. 54

9. What attire is required to enter the restricted area? a. Hair cap, mask, facial hair covering, complete scrub suit b. Scrub suit and hair cap c. Hair cap, facial hair covering, complete scrub attire d. None of the above ANS: A Only personnel in complete scrub attire, including hair cap, mask, and facial hair covering, are permitted in the restricted area.

DIF:

2

REF: p. 54

10. The purpose of floor plans is to provide efficiency, environmental safety, and in the surgical department. a. work flow b. infection control c. design d. corridor ANS: B Many different types of floor plans meet the goals of infection control, environmental safety, and efficiency.

DIF:

2

REF: p. 54

11. The air pressure in the surgical suite is maintained at a level of air pressure in adjacent semi-restricted areas. a. 20% b. 30% c. 10% d. 50%

higher than the

ANS: C Allowing airflow from unrestricted to restricted areas can increase the risk of infection. To reduce this risk, the air pressure in the surgical suite is maintained at a level 10% higher than the air pressure in adjacent semi-restricted areas.

DIF:

2

REF: p. 57

12. The standard for air exchange in the operating room is a minimum of maximum of filtered air exchanges per hour. a. 15; 20

SOURCE: Browsegrades.net

and a

b. 25; 30 c. 40; 50 d. 5; 10 ANS: A The standard for air exchange in the operating room is a minimum of 15 and a maximum of 20 filtered air exchanges per hour.

DIF:

2

REF: p. 57

13. When the operating room door is opened, the room pushes air . a. negative; in b. exchange; in c. positive; out d. all of the above

pressure from within the

ANS: C When the door is opened, the positive pressure from within the room pushes air out and prevents it from entering the suite from the semi-restricted area outside.

DIF:

2

REF: p. 57

14. The current standard for humidity in the operating room is a. 10% to 20% b. 30% to 60% c. 20% to 60% d. 40% to 70%

.

ANS: C The current standard for humidity in the operating room is 20% to 60%.

DIF: 15. a. b. c. d.

2

REF: p. 57

filtered air enters the operating room ceiling vents and is combined with air in the room.

Laminar; pressure Fresh; existing Existing; negative Positive; laminar

ANS: B Fresh filtered air enters the operating room ceiling vents and is combined with existing air in the room.

DIF:

2

REF: p. 57

16. High-efficiency particulate air (HEPA) filters are installed in the operating room ventilation system and remove particles equal to or larger than . a. 0.1 µm b. 0.2 µm

SOURCE: Browsegrades.net

c. 0.3 µm d. all of the above ANS: C High-efficiency particulate air (HEPA) filters are installed in the operating room ventilation system and remove particles equal to or larger than 0.3 µm.

DIF:

2

17. High a. LED b. humidity c. HEPA d. air pressure

REF: p. 57 may increase the risk of mold and bacterial growth on surfaces.

ANS: B High humidity may increase the risk of mold and bacterial growth on surfaces.

DIF:

2

REF: p. 57

18. The temperature in the operating room is maintained at a. 64° to 68° F b. 68° to 73° F c. 72° to 79° F d. 78° to 83° F

.

ANS: B The operating room is mainNtaUinReS dI atN6G 8°TtoB7.3C °O FM (20° to 23° C).

DIF:

1

REF: p. 57

19. Modern surgical lighting is usually derived from a. LED sources and halogen b. energy saving sources and high-definition screens c. compressed air and gas d. LED sources and light-emitting diodes

.

ANS: A Modern surgical lighting is usually derived from LED (light-emitting diode) sources and halogen.

DIF:

1

REF: p. 57

20. A laminar airflow (LAF) system moves a contained volume of air in layers at a continuous . a. current b. energy c. circuit d. velocity ANS: D

SOURCE: Browsegrades.net

A Laminar airflow (LAF) system is a ventilation system that moves a contained volume of air in layers at a continuous velocity, with 800 to 900 air exchanges per hour.

DIF:

2

REF: p. 57

21. HEPA-filtered exchanges for the laminar airflow (LAF) system range from exchanges per hour. a. 200 to 400 b. 300 to 400 c. 100 to 200 d. 400 to 600 ANS: D HEPA-filtered exchanges for the laminar airflow (LAF) system range from 400 to 600 exchanges per hour.

DIF:

2

REF: p. 57

22. All of the following are compressed gases EXCEPT a. oxygen b. suction c. nitrous oxide d. nitrogen

.

ANS: B Oxygen, compressed air, nitrous oxide, and nitrogen are available through inline systems in most hospitals and outpatieN nt sR urgiI cal G cenB te. rs.C M

U S N T

DIF:

2

O

REF: p. 57

23. The strength of vacuum of the suction is measured in a. pounds per square inch (psi) b. laminar airflow (LAF) c. light-emitting diode (LED) d. high-efficiency particulate air (HEPA)

.

ANS: A The strength of vacuum in suction is measured in pounds per square inch (psi) and is adjustable.

DIF:

1

REF: p. 57-58

24. Which piece of equipment is covered with a firm removable pad? a. Back table b. Operating table c. Mayo stand d. Prep table ANS: B The operating table surface is covered with a firm removable pad.

SOURCE: Browsegrades.net

DIF:

1

REF: p. 55

25. Which piece of equipment is the sterile pack opened onto that provides a sterile surface for instruments and supplies? a. Back table b. Ring stand c. Operating table d. Mayo stand ANS: A The back table is a large, stainless steel table on which all instruments and supplies (except those in immediate use) are placed. Just before surgery, a sterile pack (cover with towels and drapes enclosed) is opened onto the table.

DIF:

1

REF: p. 55

26. Which piece of equipment is covered with a sterile drape and placed over the patient during the procedure for quick access to instruments? a. Back table b. Mayo stand c. Ring stand d. All of the above ANS: B The Mayo stand is placed over or alongside the patient for quick access to instruments.

DIF:

1

G B.C M U S N T O

REFN : pR . 56I

27. Which piece of equipment is designed to contain sterile basins that are used during surgery? a. Kick bucket b. Prep table c. Mayo stand d. Ring stand ANS: D The ring stand is used to contain one or two stainless steel basins.

DIF:

1

REF: p. 56-57

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Unrestricted area b. Semi-restricted area c. Restricted area 1. Family waiting room 2. Surgical suite 3. Sterile instrument room

SOURCE: Browsegrades.net

4.

5.

6.

7.

8.

9.

10.

Anesthesia workroom Substerile room Closed areas for the scrub sinks Personnel must wear surgical attire (mask not necessary) Personnel must wear scrub attire, including complete head, nose, and mouth covering Personnel dressed in street clothes Corridors between surgical rooms

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS:

A C C B C C B C A B

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 54 p. 54 p. 54 p. 54 p. 54 p. 54 p. 54 p. 54 p. 54 p. 54

Choose from the terms listed and match them with their most correct description. a. Surgical offices b. Locker room/lounge area c. Patient preoperative holding area d. Scrub sinks e. Substerile room f. Sterile instrument room g. Equipment storage h. Utility workroom and decontamination area i. Clean processing area j. Anesthesia department k. Post anesthesia unit l. Surgery waiting area m. Integrated OR system 11.

12.

13.

14.

15.

16.

17.

18.

19.

Is adjacent to the OR Contains clean respiratory equipment, anesthetic agents, and adjunctive drugs Patient’s family is located outside traffic areas A front office situated near the main entry doors serves as a central communication area for the department Items that are particularly delicate or that are used infrequently may be processed in this area Provides centralized control of surgical devices and equipment through a sterile remote or voice activated system A transitional area for those who need to change from street clothes to surgical attire Sterile wrapped supplies are stored in designated restricted areas adjacent to the operating suites nearby A patient emerging from anesthesia faces many physiological risks

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20. Check-in point where the surgeon, anesthesiologist, and circulating nurse can confirm that all documentation is in order 21. Are located outside the surgical suites so that personnel can proceed directly to surgery immediately after hand antisepsis 22. Large equipment, such as the operating microscope, operating table attachments, and electrosurgical units 23. Soiled instruments and equipment are decontaminated and washed in this area 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS: 18. ANS: 19. ANS: 20. ANS: 21. ANS: 22. ANS: 23. ANS:

E J L A I M B F K C D G H

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 58 p. 59 p. 59 p. 58 p. 59 p. 59 p. 58 p. 59 p. 59 p. 58 p. 58 p. 58 p. 58

Choose from the terms listed and match them with their most correct description. Some answers will not be used. a. Organizational chart b. Chain of command c. Personnel policy d. Surgeon e. Assistant surgeon f. Anesthesia care provider g. Perioperative registered nurse h. Physician assistant i. Licensed practical nurse j. Certified surgical technologist k. Certified surgical technologist–certified first assistant l. Certified surgical assistant or nonphysician surgical assistant m. Certified anesthesia technologist n. OR educator o. Surgical orderly or aide p. Central sterile processing technician q. Patient care technician r. Radiology s. EEG technician t. Medical industry representative u. Cardiovascular perfusionist v. Administrative personnel w. Health care facility management x. Chief operation officer

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y. Director of surgical services/OR z. Perioperative nurse manager 24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

41.

42.

43.

44.

45.

46.

47.

Defines the relationship between management and staff members Assists the OR director A graphic representation of the management chain of command Is an MD, DO, or CRNA Has completed a 1- or 2-year program in a vocational or technical school A member of the anesthesia patient care team and department Transportation of the patient to and from the surgical department Specialist in measuring the brain’s activities Responsible for oversight of the health facility Employed by surgical equipment and instrument company Multidisciplinary nursing assistant Responsible for the safe management and sterilization of equipment Develops and implements educational programs Prepares equipment and instruments before surgery Responsibilities and functions of all employees in the surgical department Patient’s primary physician in the OR Is a CST who has completed an education program for assisting Medical and technical radiology professional Role is to provide extracorporeal oxygenation of the blood during CABG Responsible for overseeing all clinical and professional activities in the department Provide oversight and development of the facility’s goals and operations A medical doctor licensed N to pR erfoI rm and GTBas.siCstOinMsurgery U S N Is an RN and also may have advance certification in perioperative nursing Is a medical professional who practices medicine under the supervision of a physician

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

41.

ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS: ANS:

B Z A F I M O S X T Q P N J C D K R

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 64 p. 67 p. 67 p. 65 p. 65 p. 65 p. 66 p. 66 p. 66 p. 66 p. 66 p. 66 p. 66 p. 65 p. 64 p. 65 p. 65 p. 66

SOURCE: Browsegrades.net

42.

43.

44.

45.

46.

47.

ANS: ANS: ANS: ANS: ANS: ANS:

U Y V E G H

DIF: DIF: DIF: DIF: DIF: DIF:

1 1 1 1 1 1

REF: REF: REF: REF: REF: REF:

p. 66 p. 67 p. 66 p. 65 p. 65 p. 65

SOURCE: Browsegrades.net

Chapter 05: The Patient Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. According to Maslow’s Hierarchy of Needs, physiological needs are all of the following EXCEPT . a. psychological b. biochemical c. mechanical d. physical ANS: A According to Maslow’s Hierarchy, the most basic of human needs are physiological—those that involve the biochemical, mechanical, and physical processes of life.

DIF:

2

REF: p. 69-70

2. Supplying fluid, electrolytes, and organic substances to cells to maintain electrical activity and transport of materials in and out of the cells is a physiological response of . a. thermoregulation b. mutation c. attrition d. nutrition ANS: D Nutrition at its physiological level means supplying fluid, electrolytes, and organic substances to cells to maintain electrical activity and transport of materials in and out of the cells. It also refers to the breakdown of food into molecular components for tissue repair and growth.

DIF:

2

REF: p. 70

3. Self-actualization is one’s ability to express and achieve a. society b. financial c. professional d. personal

goals.

ANS: D Self-actualization is one’s ability to express and achieve personal goals. These are whatever that person defines as a goal or achievement. Personal goals are unique and valued by each individual person.

DIF:

2

REF: p. 72

4. In patient-centered care, the surgical team bases assessment, planning, and intervention on the unique needs of the _ .

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a. b. c. d.

surgical technologist patient surgeon patient’s family members

ANS: B In patient-centered care, the surgical team bases assessment, planning, and intervention on the unique needs of the individual patient. The unique needs of the individual patient are revealed through information from others, astute observation, and good communication.

DIF:

2

REF: p. 69

5. Maslow’s Hierarchy of Needs is a model for meeting point for patient care. a. the surgeon’s needs b. the patient’s family members’ needs c. the sterile team’s needs d. human needs

and is used as a reference

ANS: D In the 1970s, psychologist Abraham Maslow developed a theory about human needs. His model, named Maslow’s Hierarchy of Needs, is depicted as a triangular hierarchy, with the most important needs at the base levels.

DIF:

2

REF: p. 69

6. Physiological needs are theNbasR ic nI eedG s foB r .C M U S N T O a. all b. some c. young d. elderly

patients.

ANS: A All patients require the need to have their feelings understood and acknowledged.

DIF:

2

REF: p. 70

7. Pediatric patient groups are defined according to approximate a. physical b. physiological c. chronological d. astronomical

age ranges.

ANS: C Pediatric patient groups are defined according to approximate chronological age ranges. The age group reflects the developmental stage.

DIF: 8.

2

REF: p. 74

is the body’s way of avoiding painful or dangerous environments and stimuli. a. Excitement

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b. Immobility c. Calmness d. Mobility ANS: D Mobility is the body’s way of avoiding painful or dangerous environments and stimuli. In surgery, the anesthetized patient loses this ability. The caregivers must be constantly alert for environmental dangers that the patient would normally avoid.

DIF:

2

REF: p. 69

9. The malnourished patient lacks the necessary a. oxygen supply b. basic requirements c. nutritional reserves d. immune responses

to support the process of healing.

ANS: C The malnourished patient lacks the necessary nutritional reserves to support the process of healing. Protein and carbohydrates are in particularly high demand by the body to rebuild tissue and meet the physiological demands of organ systems.

DIF:

2

REF: p. 77

10. Because many patients with diabetes have compromised vascular systems, their risk of is higher than in patients who are not diabetic. a. surgical site infection b. a physiological response to anesthesia c. regression d. comorbid disease ANS: A Because many patients with diabetes have compromised vascular systems, their risk of surgical site infection is higher than in other groups. They are also subject to prolongation of wound healing, hypertension, and peripheral edema.

DIF:

2

REF: p. 78

11. The patient whose is compromised or suppressed is threatened with postoperative infection and delayed wound healing. a. respiratory system b. immune system c. basic human needs d. nervous system ANS: B The patient whose immune system is compromised or suppressed is threatened with postoperative infection and delayed healing. A healthy immune system is needed for the body to respond to the trauma of surgery and defend it against pathogens that may have invaded it during surgery.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 78

12. Knowledge of the different of children helps the surgical technologist understand the behaviors exhibited by these patients in the operating room. a. cultures b. developmental stages c. childhood diseases d. family backgrounds ANS: B Children of different developmental stages have predictable fears, responses, and reactions to hospitalization and the process of surgery. Knowledge of these stages helps the surgical technologist understand the behaviors exhibited by children in the operating room.

DIF: 13. a. b. c. d.

2

REF: p. 74

is a model of human needs.

Maslow’s Hierarchy of Needs Developmental stages Therapeutic communication Social considerations

ANS: A Maslow’s Hierarchy of Needs is depicted as a triangular hierarchy, with the most important needs at the base levels.

DIF:

2

G B.C M U S N T O

REFN : pR . 69I

14. Patients are covered with warm blankets while awaiting surgery or during transportation.

This is not just a comfort measure but is also important to maintaining temperature. a. core b. skin c. room d. equipment ANS: A The technologist contributes to temperature regulation in many ways. He or she maintains irrigation fluids to correct temperature. Thermal (body warming) devices used during surgery are the responsibility of the RN circulator and technologist who assists. The technologist ensures that patients are covered with warm blankets while awaiting surgery or during transportation. This is not just a comfort measure but is also important to maintaining core temperature.

DIF:

2

REF: p. 76

15. Toddlers experience extreme a. comfort b. anxiety c. happiness

when separated from their primary caregiver.

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d. reflexes ANS: B Toddlers suffer frustration and loss of autonomy, as well as extreme anxiety, when separated from their primary caretaker. The operating room environment can be terrifying to a toddler, who expresses this by crying and screaming or through aggression and regression.

DIF:

2

REF: p. 74

16. A system is needed for the body to respond to the trauma of surgery and to defend it against pathogens that have invaded it during the surgical procedure. a. mobility b. healthy immune c. elimination d. comorbid disease ANS: B A healthy immune system is needed for the body to respond to the trauma of surgery and defend it against pathogens that may have invaded it during surgery.

DIF:

2

REF: p. 78

17. Which is the highest level of Maslow’s Hierarchy of Needs? a. Love b. Belonging c. Acceptance d. Self-actualization ANS: D Self-actualization is the highest level of Maslow’s model. It is the individual’s ability to plan and achieve his or her life goals based on the physical, social, and psychological freedom to pursue those achievements.

DIF:

2

REF: p. 70

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Basic need b. Psychological need c. Spiritual need 1.

2.

3.

4.

5.

6.

7.

Belief in a greater power Respiration Practice of a particular faith Anxiety and fear Loss of security Biochemical needs Fear of death

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8. Rituals and ceremonies 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS:

C A C B B A B C

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF: REF:

p. 73 p. 70 p. 73 p. 71 p. 71 p. 70 p. 71 p. 73

SOURCE: Browsegrades.net

Chapter 06: Diagnostic and Assessment Procedures Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Contrast media instilled into the urinary tract for visualization of the bladder, ureters, and kidney is called . a. myelography b. cholangiography c. angiography d. retrograde pyelography ANS: D In retrograde pyelography, contrast media is instilled into the urinary tract for visualization of the bladder, ureters, and kidney. This procedure is used to identify stones, strictures, tumors, or other anomalies in the urinary system.

DIF:

2

REF: p. 92

2. Because is found in contrast media, the patient must be evaluated for potential hypersensitivity before administration. a. radioactive material b. penicillin c. iodine d. latex ANS: C Contrast radiography carries a risk of allergy to the radiopaque media, especially when the agent is injected. A careful patient history is used to determine whether the patient had any previous reaction to contrast media. Allergy to iodine or agents containing iodophor may indicate sensitivity to contrast media.

DIF: 3.

2

REF: p. 92

is a radiopaque element that is used in the radiographic examination of the gastrointestinal (GI) tract. a. Barium b. Optiray c. Conray d. Renografin ANS: A In studies of the GI system, barium is a radiopaque element used to fill and outline the structures. An upper GI study is used to identify the esophagus, stomach, and small intestine. The large intestine is studied after instillation of barium into the distal colon and rectum.

DIF:

2

REF: p. 92

SOURCE: Browsegrades.net

4.

uses radiofrequency signals and multiple magnetic fields to produce a high-definition image. a. Fluoroscopy b. Computed tomography (CT) c. Positron emission tomography (PET) d. Magnetic resonance imaging (MRI) ANS: D Magnetic resonance imaging (MRI) uses radiofrequency signals and multiple magnetic fields to produce a high-definition image. In this process, the patient is exposed to electromagnetic energy, which is emitted inside a closed body tube or open platform. MRI produces two- or three-dimensional digital images in cross section and is used mainly for the detection of structural abnormalities, including tumors.

DIF:

2

REF: p. 93

5. Intraoperative radiation therapy is used to deliver specific area of the body. a. multiple b. a single c. a weak d. a small

dose(s) of radiation to a

ANS: B Intraoperative radiation therapy is used to deliver a single dose of radiation to a specific area of the body.

DIF:

2

N R I G B.COM

REF: Up. 9S8 N T

6. In assessment of blood pressure, the difference between diastolic and systolic pressure is called the pressure. a. pulse b. systolic c. mean arterial d. diastolic ANS: A When the blood is forcefully pumped through the left ventricle, pressure is at its greatest.

This is called the systolic pressure. As the heart muscle relaxes between contractions, blood pressure is lowered. This is called diastolic pressure. When blood pressure is assessed, the difference between diastolic and systolic pressure can be a significant sign. This is called the pulse pressure.

DIF:

2

REF: p. 86

7. The _ is a basic test used to evaluate the type and percentage of normal components in the blood. a. arterial blood gases (ABCs) b. metabolic panel c. complete blood count (CBC)

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d. white blood count (WBC) ANS: C The CBC is a basic test used to evaluate the type and percentage of normal components in the blood. A blood sample is drawn from the vein and centrifuged. This separates it into cellular and liquid components for evaluation.

DIF: 8. a. b. c. d.

2

REF: p. 94

studies are used to measure blood flow.

MRI X-ray Endoscopy Doppler

ANS: D Doppler studies use ultrasound for specific measurement of vascular flow.

DIF:

2

REF: p. 93

9. The produces characteristic patterns indicating normal or abnormal conduction impulses that stimulate heart action. a. electrocardiogram (ECG) b. neuromonitoring c. Doppler d. ultrasound ANS: A The ECG measures the electrical activity of the heart and displays it on a graph for evaluation. To obtain the readings, electrodes are placed at strategic locations on the chest wall and extremities. These coincide with the heart’s conductivity pattern.

DIF:

2

REF: p. 88

10. A test that includes results of blood glucose, carbon dioxide, creatinine, urea nitrogen, bicarbonate, and several important electrolytes is called a . a. urinalysis b. differential leukocyte count c. coagulation test d. metabolic panel ANS: D The metabolic panel includes a number of different tests to determine serum levels of substances that are crucial for metabolism. There are many different types of metabolic panels. The basic metabolic panel includes blood glucose, carbon dioxide, creatinine, urea nitrogen, bicarbonate, and several important electrolytes. The exact tests included in any metabolic panel are determined by health care regulatory agencies and may change with reimbursement regulations.

DIF:

2

REF: p. 94-95

SOURCE: Browsegrades.net

11.

, or decreased serum potassium, can result from persistent and severe vomiting and diarrhea, from extensive tissue trauma, or from shock. a. Hypokalemia b. Hyperkalemia c. Hyponaturemia d. Hypocalcemia ANS: A Hypokalemia (decreased serum potassium) can result from persistent and severe vomiting and diarrhea, from extensive tissue trauma, or from shock. Certain drugs also can cause a drop in potassium.

DIF:

12. A a. b. c. d.

2

REF: p. 95

is composed of disorganized tissue that exhibits uncontrolled growth. benign tumor malignant tumor tumor marker tumor growth

ANS: B A malignant tumor is composed of disorganized tissue that exhibits uncontrolled growth.

Malignant tissue has the potential to spread from the original site (called the primary tumor) to other parts of the body.

DIF: 13.

2

REF: p. 97

N R I G B.C M

has/haUve S impN ortaT nt functO ions in the blood-clotting mechanism, including clot retraction and activation of coagulation factor. a. Platelets b. Hemoglobin c. Red blood cells d. White blood cells ANS: A Platelets have important functions in the blood-clotting mechanism, including clot retraction and activation of coagulation factor.

DIF:

14.

2

REF: p. 94

is necessary for the transmission of nerve impulses to skeletal, smooth, and cardiac muscle. a. Sodium b. Potassium c. Calcium d. Magnesium ANS: B Potassium is found mainly in the cells. It is necessary for the transmission of nerve impulses to skeletal, smooth, and cardiac muscle. It also functions in the conversion of carbohydrates for cellular energy and is critical in maintaining osmolality in the cells.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 95

15. Molecules of inorganic substances that are essential for homeostasis and are capable of splitting to yield a charged particle or substance are called . a. electrolytes b. cardiac enzymes c. glucose levels d. sodium levels ANS: A Body fluids contain both organic and inorganic substances. These substances are essential for homeostasis. Molecules of inorganic substances are capable of splitting to yield a charged particle or substances called electrolytes.

DIF:

2

REF: p. 95

16. Two primary tests that are performed on surgical patients to evaluate blood and blood cells are . a. CBC and differential leukocyte count b. cardiac enzyme and glucose level studies c. urinalysis and electrolyte study d. type and cross-match and type and screen ANS: A The CBC is a basic test used to evaluate the type and percentage of normal components in the blood. The CBC is a basic blood test used for screening infections and many other types Ncyte RScoIN G B.Cblood M cells (leukocytes) are essential to the of disease. Differential leukoU unt:TWhite O immune process. The differential count measures the number of each type of leukocyte by volume of blood. These are monocytes, macrophages, band neutrophils, eosinophils, basophils, and lymphocytes.

DIF:

2

REF: p. 94

17. Normal oral temperature in a person at rest is a. 42° C b. 47° C c. 52° C d. 37° C

.

ANS: D Oral temperature is measured under the tongue (sublingual), which is highly vascular and accurately reflects core temperature. Normal oral temperature in a person at rest is 37° C (98.6° F). The range is 35.8° to 37.3° C (96.4° to 99.1° F).

DIF:

2

18.

REF: p. 84 is/are the oxygen-carrying protein attached to RBCs.

a. Platelets b. Hematocrit

SOURCE: Browsegrades.net

c. Leukocytes d. Hemoglobin ANS: D Hemoglobin is the oxygen-carrying protein attached to RBCs (erythrocytes).

DIF: 19.

2

REF: p. 94

can result from parathyroid disease, vitamin D deficiency, and specific drugs such as corticosteroids and some diuretics. a. Hypocalcemia b. Hyponaturemia c. Hematocrit d. Hemoglobin ANS: A Hypocalcemia can result from parathyroid disease, vitamin D deficiency, and specific drugs such as corticosteroids and some diuretics.

DIF:

2

REF: p. 96

20. Basic diagnostic indicators that are used to evaluate the patient’s condition are . a. vital signs b. x-rays c. imaging studies d. Doppler studies ANS: A Taking the patient’s vital signs provides an overall evaluation of well-being. It is the most basic form of assessment. In some facilities, the technologist may measure the patient’s vital signs.

DIF:

2

21.

REF: p. 84 is measured with a sphygmomanometer and a stethoscope.

a. b. c. d.

Blood pressure Pulse by palpation Hemoglobin Metastasis

ANS: A Blood pressure is measured with an electronic (digital) sphygmomanometer or manual sphygmomanometer, which requires a stethoscope. The stethoscope method provides a more thorough assessment.

DIF:

2

REF: p. 87

22. The measures hemoglobin, hematocrit, platelet, and leukocytes. a. metabolic panel b. CBC

SOURCE: Browsegrades.net

c. imaging study d. ABO ANS: B The CBC is a basic test used to evaluate the type and percentage of normal components in the blood. A blood sample is drawn from the vein and centrifuged. This separates it into cellular and liquid components for evaluation. The CBC is a basic blood test used for screening and diagnosis. When a diagnosis is formulated, variations in normal blood values are always considered with other signs and symptoms—never in isolation.

DIF: 23.

2

REF: p. 94

tests and procedures are those that do not require an incision or the perforation of intact tissues or structures. a. Invasive b. Noninvasive c. CBC d. Fluoroscopy ANS: B Noninvasive procedures are limited to skin contact or no direct contact with the body.

DIF:

2

REF: p. 83

24. Cesium-137, iodine-125, and iridium-192 are into the tumor mass. a. contrast mediums b. radioactive seeds c. metabolic panels d. cardiac enzymes

that are implanted directly

ANS: B Radioactive seeds are implanted directly into the tumor mass and may be left in the patient indefinitely. Cesium-137, iodine-125, and iridium-192 are used in this procedure. Seeds are generally used in tumors that cannot be removed by surgical resection because of precarious location or size.

DIF:

2

REF: p. 98

25. Electrolytes are vital for and are responsible for nerve impulses, fluid balance, transport of substances in and out of the cell, and balancing blood pH. a. homeostasis b. hemostasis c. staging d. systolic pressure ANS: A Electrolytes are vital for homeostasis and are responsible for nerve impulses, fluid balance, transport of substances in and out of the cell, and for balancing blood pH. They also contribute to blood clotting, electrical activity in the cell, and energy conversion.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 95

26. The term a. radiopaque b. radiolucent c. fluoroscopy d. palpating

refers to substances that the x-ray cannot penetrate.

ANS: A The term radiopaque refers to substances that the x-ray cannot penetrate.

DIF:

2

27.

REF: p. 89 is/are the most basic form of assessment.

a. b. c. d.

CT scan Chest radiograph ECG Vital signs

ANS: D Taking a patient’s vital signs allows an overall evaluation of the person’s well-being. This is the most basic form of clinical assessment. In some facilities, the surgical technologist may measure the patient’s vital signs. These are documented and reported to the registered nurse or surgeon. The surgical technologist is not expected to interpret the measurements or make a diagnosis based on the results. However, accurate measurement is always required. The vital signs include temperature, pulse, respiration, and blood pressure.

DIF:

2

N R I G B.COM

REF: Up. 8S4 N T

28. The body requires a core (deep) temperature of approximately 99° F, or a. 37.2° C b. 38.2° C c. 40° C d. 42° C

.

ANS: A The body requires a core (internal) temperature of approximately 99° F (37.2° C) to maintain physiological functions.

DIF:

2

REF: p. 84

29. Axillary temperature readings are a. 0.3° to 0.6° C higher b. 0.5° to 1° F lower c. 0.5° and 1.5° C lower d. 0.6° and 1.6° C higher

than oral measurements.

ANS: B The axillary temperature is measured at the axilla. Readings are 0.5° to 1° F (0.3° to 0.6° C) lower than the oral value.

SOURCE: Browsegrades.net

DIF: 30. a. b. c. d.

2

REF: p. 84

varies with environmental changes.

Forehead or skin temperature Blood pressure Pulse rate Pulse oximetry

ANS: A The forehead, or skin, temperature varies with environmental changes.

DIF:

2

REF: p. 84

31. Which statement about the use of thermometers is true? a. The use of external thermometers, such as the tympanic thermometer, poses less risk of infection for your patient. b. You do not need to wash your hands after taking a patient’s temperature with a forehead or skin thermometer because it is not an invasive procedure. c. The rectal method is preferred over the tympanic method. d. Tympanic thermometers can harbor an infectious biofilm that may not be visible.

ANS: D Always wear gloves when taking the patient’s temperature. Probe and tympanic thermometers can harbor an infectious biofilm that may not be visible.

DIF:

2

REF: p. 84

N R I G B.C M

32. The pulse is a reflection of thU e stS rokeNvoT lume orO_ a. amount of input b. amount of oxygen in the blood c. amount of blood pumped through the heart d. amount of blood pumped from the heart into the aorta

.

ANS: C The pulse is a reflection of the stroke volume (amount of blood pumped through the heart) of each beat. The pulse is felt in the artery as it expands with each heartbeat. The normal heart rate varies according to age, condition, and metabolic level.

DIF:

2

REF: p. 85

33. The normal pulse rate for an adult is a. 40 to 60 beats per minute b. 60 to 100 beats per minute c. 75 to 100 beats per minute d. 80 to 120 beats per minute ANS: C A normal pulse rate for an adult is 75 (60 to 100).

DIF:

2

REF: p. 85

SOURCE: Browsegrades.net

.

34. All the following are ways that malignancy causes specific injury to the body EXCEPT . a. cachexia b. anemia c. no pain d. blood clot ANS: C Malignancy causes specific injury to the body: • The risk of thrombosis (blood clot) is increased as a result of inappropriate production of clotting factors by the tumor itself. The tumor may also block blood vessels, resulting in clotting.

• Pain is caused by direct injury to tissue or by pain mediators released by the tumor. As the tumor impinges on healthy tissue, the tissue dies, resulting in severe pain.

• Cachexia (tissue and body wasting) is characteristic of malignancy. As the tumor destroys tissue, the patient’s metabolism is altered. Nutrients normally received by healthy tissue for growth and repair are captured by the malignant tissue, which continues to grow and spread.

• Anemia occurs as a result of internal bleeding and the body’s inability to replace red blood cells.

• As the malignancy spreads, changes occur in the function of the target tissue. This results in many different disease conditions, depending on the organ or tissue function.

DIF: 35.

2

a. ECG

REF: p. 97 provides detailed information about heart conduction.

b. EEG c. Blood pressure d. Oximetry ANS: A As a diagnostic tool, an ECG provides detailed information about heart conduction. Each phase of the cardiac conduction system is represented on the graph.

DIF:

2

REF: p. 88

36. The basic metabolic panel includes all of the following EXCEPT a. blood glucose b. carbon dioxide c. creatinine d. oxygen

.

ANS: D The metabolic panel includes a number of tests to determine serum levels of substances that are crucial for metabolism. Many types of metabolic panels can be done. The basic metabolic panel includes blood glucose, carbon dioxide, creatinine, urea nitrogen, bicarbonate, and several important electrolytes.

DIF:

2

REF: p. 94-95

SOURCE: Browsegrades.net

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Standard x-ray b. MRI c. Contrast radiography d. Ultrasound 1. Produces two- or three-dimensional digital images in cross section 2. Taken when a surgical count cannot be resolved and there is risk of an item left in the patient 3. Any metal in range of the device may be drawn toward the source of emission.

4. A gel coating is used when the probe is applied to skin.

5. Used in vascular surgery to track the movement of blood when combined with the Doppler 6. Uses radiofrequency signals and multiple magnetic fields to produce a high-definition image 7. Uses high-frequency sound waves 8. Cholangiography and angiography 9. Carries a risk of allergy to the radiopaque media 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS:

B A B D D B D C C

DIF: 3 REF: p. 93 DIF: 3 REF: p. 89 DIF: 3 REF: p. 93 DIF: 3 R EF: p. 93 COF:M p. 93 DIF:NU3RSINGTB.RE DIF: 3 REF: p. 93 DIF: 3 REF: p. 93 DIF: 3 REF: p. 92 DIF: 3 REF: p. 92

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. CBC b. Electrolyte c. Coagulation test d. Urinalysis 10.

11.

12.

13.

14.

15.

16.

17.

18.

Inorganic substances essential for homeostasis Used to monitor patients who are receiving antiplatelet drugs Potassium, sodium, and magnesium The pH and specific gravity are assessed Measures hemoglobin and hematocrit Measures the number of each type of leukocyte PT and PTT Assesses color, clarity, and odor Positively charged are called cations and negatively charged are called anions

SOURCE: Browsegrades.net

19. A sample is drawn from the vein and centrifuged 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS: 18. ANS: 19. ANS:

B C B D A A C D B A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 95 p. 95 p. 95 p. 96 p. 94 p. 94 p. 95 p. 96 p. 95 p. 94

SOURCE: Browsegrades.net

Chapter 07: Environmental Hazards Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The most common source of transmission of injuries. a. blood-borne pathogens b. airborne transmission c. oxidized tissue residue d. laser plume

to health care workers is sharps

ANS: A The most common means of transmission of blood-borne pathogens to health care workers is sharps injuries. Sharps are such a threat to health care personnel that OSHA has issued the Blood-Borne Pathogen Rule, a special set of regulations for handling and disposing of sharps.

DIF:

2

REF: p. 113

2. All workers in the health care setting should be vaccinated against a. potentially infectious materials b. blood-borne pathogens c. hepatitis B d. HIV

.

ANS: C All health care employees should be immunized against the hepatitis B virus (HBV).

DIF:

2

REF: p. 114

3. Scalpel blades must be mounted and removed using a. sterile gloves b. the neutral zone technique c. an instrument d. your fingers

.

ANS: C Scalpel blades must be mounted and removed with an instrument.

DIF: 4.

2

REF: p. 113

is/are implemented to reduce the risk of infectious disease transmission that are spread from the mouth, nose, oropharynx, and trachea to a susceptible host. a. Contact precautions b. Transmission-based precautions c. Face, eye, and body protection d. Droplet precautions ANS: D

SOURCE: Browsegrades.net

Droplet precautions are implemented to reduce the risk of infectious disease transmission by large, moist aerosol droplets. These are spread from the mouth, nose, oropharynx, and trachea to a susceptible host.

DIF:

2

REF: p. 114

5. The most common source of electrical injury to the surgical patient is a. a bipolar b. the electrosurgical unit (ESU) c. the chemical telescope warmer d. the irrigating solutions

.

ANS: B The most common source of electrical injury to the surgical patient is the ESU. DIF: 6.

2

REF: p. 119

is the statistical probability of a harmful event and is defined as the number of harmful events that occur in a given population over a stated period. a. Prevention b. Risk c. Awareness d. Recording ANS: B Risk is the statistical probability of a harmful event; it is defined as the number of harmful events that occur in a givenNpoR pulaI tionGovB er.aC statM ed period.

U S N T

DIF: 7. a. b. c. d.

2

O

REF: p. 101

is/are a leading cause of hospital fires in the United States.

Electrical malfunctions Smoking Laser malfunctions Arson

ANS: A Electrical malfunctions are a leading cause of hospital fires in the United States.

DIF:

2

REF: p. 108

8. The characteristics of electricity are current, voltage, resistance, and grounding. The discharge of electrical current from the source to ground, where it is dispersed and rendered harmless, is . a. current b. voltage c. grounding d. resistance ANS: C

SOURCE: Browsegrades.net

Grounding is the discharge of electrical current from the source to ground, where it is dispersed and rendered harmless.

DIF:

1

REF: p. 109

9. The zone is a hands-free space (designated receptacle) on the sterile field where sharps can be placed and retrieved so that the surgical technologist and surgeon do not hand instruments to each other directly. a. scalpel b. sharps c. free zone d. neutral ANS: D The neutral zone (no-hands) technique during surgery was developed because the evidence shows that most sharps injuries in surgery occurred when instruments are passed and received.

DIF:

2

REF: p. 113

10. Immediate action taken during a fire is described by the acronym a. RACE b. ABC c. PASS d. MSDS

.

ANS: A If the fire extends beyond the immediate patient area, the surgical team must activate the hospital evacuation plan. This plan is based on four immediate actions, which are easily remembered by the acronym RACE: Rescue patients in the immediate area of the fire. Alert other people to the fire so that they can assist in patient removal and response. Activate the fire alert system. Contain the fire. Shut all doors to slow the spread of smoke and flame.

Always shut off the zone valves controlling inline gases to the room. Evacuate personnel in the areas around the fire.

DIF:

2

11.

REF: p. 103 solutions are common and frequent sources of fuel in surgical fires.

a. b. c. d.

Irrigation Antibiotic Prep Disinfecting

ANS: C After prepping, allow the prep solution to dry and the fumes to dissipate. Wet prep and fumes trapped beneath drapes can ignite.

DIF:

2

REF: p. 102

SOURCE: Browsegrades.net

12. To lift or transfer a patient, use your body. a. arm b. back c. leg d. abdominal

muscles to hold the weight of your upper

ANS: D To lift or transfer a patient, use your abdominal muscles to hold the weight of your upper body. When the abdominal muscles are not engaged in exertion, the back muscles, especially those in the sacral and lumbar region, must support the entire trunk; this is a common cause of back injury.

DIF:

2

REF: p. 118

13. Clothing or equipment that prevents the wearer from direct contact with hazardous chemicals or potentially infectious body fluids is called . a. airborne transmission exposure precautions b. transmission-based precautions c. personal protective equipment d. post-exposure prophylaxis ANS: C Personal protective equipment is clothing or equipment that prevents the wearer from direct contact with hazardous chemicals or potentially infectious body fluids.

DIF:

2

G B.C M U S N T O

REFN : pR . 11I 0

14. Compressed gases in steel cylinders are associated with serious accidents and fatalities related to of the tank. a. opening and closing b. connecting and disconnecting c. transporting and storage d. explosion or rupture ANS: D Compressed gases in steel cylinders are associated with serious accidents and fatalities related to explosion or rupture of the tank.

DIF:

2

REF: p. 104

15. All fires require three components: fuel, a source of ignition, and oxygen. makes the operating room (OR) a high-risk environment for fire. a. A large amount of combustible material b. A high concentration of oxygen c. high-energy equipment d. Volatile prep solutions ANS: B Fire requires three components: • Oxygen (available in the air or as a pure gas)

SOURCE: Browsegrades.net

• Fuel (a combustible material) • Source of ignition (usually in the form of heat) These components are commonly present in the OR. DIF:

2

REF: p. 101

16. Patient area fires are extremely serious. The surgical technologist and all other surgical team members must know how to react. Protection of is the primary concern. a. the immediate patient area b. the patient c. patient records d. patient and staff ANS: B Patient area fires are extremely serious. The surgical technologist and all other surgical team members must know how to react. Protection of the patient is the primary concern.

DIF: 17.

2

REF: p. 103

is created during the use of a laser or an ESU. It contains toxic chemicals, vapors, blood fragments, and diseases. a. A smoke plume b. A chemical hazard c. Infectious waste d. Ionizing radiation ANS: A A smoke plume is created during the use of a laser or an ESU. It contains toxic chemicals, vapors, blood fragments, and diseases.

DIF:

1

REF: p. 110-111

18. A naturally occurring sap obtained from rubber trees and used in the manufacture of medical devices and other commercial goods is known as _ . a. latex b. glutaraldehyde c. grounding d. volatile ANS: A Latex is a naturally occurring sap obtained from rubber trees. It is used commercially in the manufacture of many products, including medical devices, supplies, and patient care items.

DIF:

2

REF: p. 115

19. Although are uncomfortable and heavy, team members should wear them under their sterile gowns during any procedure that requires radiation. a. dosimeters b. lead aprons c. electrosurgical units

SOURCE: Browsegrades.net

d. oxidizers ANS: B Although lead aprons are uncomfortable and heavy, team members should wear them under their sterile gowns during any procedure that requires radiation. Many lead aprons shield only the front of the body; therefore workers should face the radiation source during exposure.

DIF:

2

20.

REF: p. 109 are used with laser and electrosurgical equipment to prevent disease

transmission. a. Efficient evacuation and filtering systems b. Special filtered masks c. Post-exposure prophylaxis (PEP) d. Oxidizers ANS: A All safety organizations including the National Institute for Occupational Safety and Health (NIOSH) recommend an efficient evacuation and filtering system. A suction tip at the exact site where smoke is generated filters the smoke and absorbs minute toxic particles.

DIF:

2

REF: p. 110-111

21. The recommended procedure to help prevent the development of blood-borne diseases after an exposure incident is . a. standard precautions b. post-exposure prophylaxis (PEP) c. special filtered masks d. electrosurgical units ANS: B PEP is a risk-reduction strategy that is used after exposure to blood or other body fluids. It involves the administration of drugs and testing. PEP is voluntary; no health care worker should be coerced into receiving it.

DIF:

2

REF: p. 113

22. Protective barriers must be used to reduce the risk of skin and mucous membrane exposure to . a. potentially infectious material b. foul odors c. latex d. oxidizers ANS: A Protective barriers must be used to reduce the risk of skin and mucous membrane exposure to potentially infectious material.

DIF:

1

REF: p. 112

SOURCE: Browsegrades.net

23. Guidelines recommended to reduce the risk of transmission of blood-borne and other pathogens are called precautions. a. universal b. standard c. traditional d. limited ANS: A Guidelines recommended to reduce the risk of transmission of blood-borne and other pathogens are called universal precautions.

DIF: 24. a. b. c. d.

2

REF: p. 111

affect muscle control, which can lead to injury.

Temperature and humidity Fatigue and stress Sharps and latex Oxidizers and eschar

ANS: B Fatigue and stress affect muscle control, which can lead to injury. Standing and walking for long periods puts extra stress on muscles, tendons, and joints.

DIF:

2

REF: p. 117

MATCHING Choose from the terms listed and match them with their most correct descriptions. You may use the same answer more than once. a. Standard precautions b. Transmission-based precautions c. Airborne transmission precautions d. Droplet precautions e. Contact precautions 1. Standards and precautions to prevent the spread of infectious disease by patients known to be infected 2. Formerly called universal precautions 3. Implemented to reduce the risk of infectious disease transmission by large, moist, aerosol droplets 4. These precautions must be used with tuberculosis and measles patients.

5. Precautions used when a patient is known to have impetigo or infection with any multidrug resistant bacterium 6. Used when the patient is known to have an infection known to be transmitted by direct contact 7. Reduces the risk of transmission of airborne agents by droplet nuclei of 5 µm or less 8. Personnel must use these precautions when in contact with patients infected with influenza, rubella, and streptococcal pharyngitis 9. All patients are considered potential carriers of diseases

SOURCE: Browsegrades.net

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS:

B A D C E E C D A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 114 p. 111-112 p. 114 p. 114 p. 114 p. 114 p. 114 p. 114 p. 112

Match the correct term about radiation to the correct definition. You may use the same answer more than once. a. Ionizing radiation b. Magnetic resonance imaging 10. Lead aprons must be worn during fluoroscopy to prevent exposure to scatter radiation.

11. Lead aprons must be stored flat or hung in a manner that prevents bending of the material.

12. Remember that a lead apron protects only the areas of the body that are covered by the apron.

13. The primary risk is the presence of metal, which can be drawn from its source and into the path of the powerful magnetic field. For this reason, absolutely no metal objects are permitted in the environment during this process.

14. The eyes and hands are not protected.

15. Those who must remain in the room during exposure must maintain a distance of at least 6 feet (1.8 m) from the patienNt.URSINGTB.COM 16. Neck shields are available to protect the thyroid, which is sensitive to radiation, during fluoroscopy.

17. Personal items, such as scissors or jewelry 18. Nonsterile workers should step outside the range of exposure, either behind a lead screen or outside the room.

10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS: 18. ANS:

A A A B A A A B A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 109 p. 109 p. 109 p. 110 p. 109 p. 109 p. 109 p. 110 p. 109

SOURCE: Browsegrades.net

Chapter 08: Microbes and the Process of Infection Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. a. b. c. d.

provide a form of adaptive immunity.

Antibiotics Allergies Vaccinations Resident flora

ANS: C Vaccination provides a form of adaptive immunity. Vaccines are modified forms of disease organisms that create immunological memory in the body. They produce the same immunological response as the disease itself, without the risks involved in the disease process. Vaccination provides artificial immunity against specific organisms.

DIF:

2

REF: p. 142

2. The human intestinal tract contains many different types of bacteria, such as which are essential for metabolism. a. Pseudomonas aeruginosa b. Streptococcus pyogenes c. Staphylococcus aureus d. Escherichia coli

,

ANS: D For example, the human intestinal tract contains many different types of bacteria such as Escherichia coli, which are essential for metabolism. The bacteria survive in balance with the body as long as they remain in the intestine.

DIF:

2

REF: p. 127

3. A(n) is the state or condition in which the body or body tissues are invaded by pathogenic microorganisms that multiply and produce injurious effects. a. infection b. disease c. inflammation d. exotoxin ANS: A The state or condition in which pathogenic microorganisms invade and colonize in the body or body tissues is an infection.

DIF: 4.

2

REF: p. 127-128

is the movement of liquid through a semipermeable membrane according to differences in the concentration of substances on either side. a. Mutualism

SOURCE: Browsegrades.net

b. Comensualism c. Diffusion d. Osmosis ANS: D When the particles cross a permeable membrane, such as that of a cell, it is called osmosis.

DIF:

2

REF: p. 124

5. Microbes enter the body through a location called the a. portal of entry b. microbe host c. vaginal lactobacilli d. intestinal tract

.

ANS: A It is important to note that specific microbes (mainly bacteria) can infect and cause disease in many different body systems and tissues, depending on the condition of the host, the portal of entry of the microbe, and complex biochemical conditions in the cell environment.

DIF:

2

REF: p. 129

6. A wound is described as when exudate (accumulation of pus, drainage, dead cells, and serum) may appear around the incision. a. suppurative b. abscessed c. necrotic d. dehisced ANS: A Exudate (an accumulation of pus, drainage, dead cells, and serum) may appear around an incision. The wound then is described as suppurative.

DIF:

2

REF: p. 130

7. When organisms of two different species live together, this is called a. symbiosis b. immunodeficiency c. host d. parasitism

.

ANS: A The process by which organisms of two different species live together is called symbiosis.

DIF: 8.

2

REF: p. 144 is the most widespread cause of surgical site infections.

a. b. c. d.

Streptococcus pyogenes Pseudomonas aeruginosa Staphylococcus aureus Salmonella enterica

SOURCE: Browsegrades.net

ANS: C Staphylococcus aureus (S. aureus) is the most widespread cause of surgical site infections.

It normally resides in healthy skin. However, when transmitted to the surgical wound by direct or indirect contact, it can cause an infection.

DIF: 9. a. b. c. d.

2

REF: p. 133

are single-celled prokaryotic organisms.

Antigens Aerosol droplets Bacteria Droplet nuclei

ANS: C Bacteria are single-celled prokaryotic organisms. They represent a very large population of microbes in the environment and affect animals and humans as well as plants.

DIF:

2

REF: p. 124

10. The nature of the bacterial cell membrane determines a bacterium’s response to antibiotics. a. identity b. ability to invade the body’s defense system c. preexisting disease d. Gram stain classification

and its

ANS: D Gram staining is routinely performed to differentiate bacteria into two primary classifications: gram positive and gram negative.

DIF: 11. a. b. c. d.

2

REF: p. 126

is/are a long filament that is responsible for bacterial motility.

Genetic material Flagellum Appendages Organelles

ANS: B A long filament that extends from the surface of the cell is called a flagellum. This structure may occur as a single strand or in small “tufts.” The flagella provide a means of motility for the prokaryotic cell.

DIF:

2

REF: p. 141

12. Bacteria that cannot live in the presence of oxygen are called a. anaerobes b. aerobes c. spores d. endotoxins

SOURCE: Browsegrades.net

.

ANS: A Some bacteria cannot live in the presence of oxygen. These are called strict anaerobes.

Anaerobes are important in the process of infection because they can proliferate in deep traumatic or surgical wounds.

DIF:

2

REF: p. 132

13. The of bacteria growth is characterized by active and sometimes rapid cell division. a. stationary phase b. exponential (log) phase c. lag phase d. death phase ANS: B The exponential (log) phase is characterized by active and sometimes rapid cell division.

The rate is usually constant depending on the growth medium. This rate is often referred to as the doubling time or generation time of the bacteria.

DIF:

2

REF: p. 132

14. The laboratory test to determine the thickness of a microbe’s cell wall is a. Gram staining b. acid-fast staining c. culture and sensitivity d. biochemical testing ANS: A Gram staining is routinely performed to differentiate bacteria into two primary classifications. The bacterial cell wall contains a layer of sugars and amino acids. In some bacteria this wall is very thin, whereas in others it is thick.

DIF: 15.

2

REF: p. 126

is a potentially lethal pathogen that can cause surgical site infection and can spread via the lymphatic system to other sites in the body, causing anaerobic cellulitis (infection of the subcutaneous tissue) and tissue necrosis (death). a. Staphylococcus epidermidis b. Pseudomonas aeruginosa c. Klebsiella d. Streptococcus pyogenes ANS: D Many hospital-acquired infections are caused by Streptococcus pyogenes (group A beta-hemolytic streptococcus). These potentially lethal pathogens cause surgical site infection and can spread via the lymphatic system to other sites in the body, causing anaerobic cellulitis (infection of the subcutaneous tissue) and tissue necrosis (death).

DIF:

2

REF: p. 134

SOURCE: Browsegrades.net

.

16.

is an anaerobic bacteria, referred to as “gas gangrene,” that causes rapid tissue death in deep wounds deprived of oxygen. a. Clostridium perfringens b. Clostridium tetani c. Rickettsiae d. Mycobacterium ANS: A Clostridium perfringens is an anaerobic bacterium causing rapid tissue death in deep wounds deprived of oxygen. It is a relatively rare infection but does occur in health care settings. It was commonly seen in combat wounds characterized by gas gangrene.

DIF:

17.

2

REF: p. 134

is transmitted via blood-to-blood contact, sexual contact, and contact with certain body fluids. a. CDC b. AIDS c. HPV d. HIV ANS: D HIV is transmitted via blood-to-blood contact, sexual contact, and contact with certain body fluids. The following fluids are known to transmit HIV: • Blood • Semen • Vaginal secretions • Breast milk • Cerebrospinal fluid • Synovial fluid • Amniotic fluid • Any body fluid containing blood DIF:

18.

2

REF: p. 138

is not a separate disease organism but a syndrome that occurs because of infection with the human immunodeficiency virus. a. AIDS b. HBV c. RNA d. Creutzfeldt-Jakob disease (CJD) ANS: A AIDS is not a separate disease organism but a syndrome that results from infection with the HIV virus. The AIDS patient lacks normal immune response, and certain diseases are common in this population.

DIF:

19.

2

REF: p. 138 infection is a term for hospital-acquired infection (HAI).

SOURCE: Browsegrades.net

a. b. c. d.

Nosocomial Community-acquired Vector Opportunistic

ANS: A A nosocomial infection is defined as an alternative term for HAI, or an infection that is acquired as a result of being in a health care facility.

DIF: 20. a. b. c. d.

1

REF: p. 129

occurs in the period immediately after trauma.

The inflammatory response Antimicrobial resistance Virulence Aerosol acceptance

ANS: A The inflammatory response is the body’s response—an innate immune response—to injury.

DIF:

1

REF: p. 142

21. When a pathogenic or nonpathogenic microorganism gains entry to a wound’s sterile tissues and colonizes there, it is called . a. disease transmission b. surgical site infection c. antimicrobial resistance N R I G B.C M O d. inflammatory response U S N T ANS: B Surgical site infection begins when a pathogenic or nonpathogenic microorganism colonizes in sterile tissues.

DIF:

1

REF: p. 129

22. Cellular organisms are divided into two types: descending from different groups. a. prokaryotes and eukaryotes b. cytoplasm and organelles c. contaminated and sterile d. diffused and cultured

, with each

ANS: A The cell is the basic unit of a living organism. Cellular organisms are divided into two types: prokaryotes and eukaryotes, with each descending from different groups.

DIF: 23.

1

REF: p. 122

is a rare transmissible disease that attacks the central nervous system, is progressive, and is always fatal. a. Hepatitis A virus

SOURCE: Browsegrades.net

b. CJD c. Convalescence d. Helicobacter pylori ANS: B CJD is a rare transmissible disease of the nervous system that is progressive and always fatal. The virus cannot be killed by ordinary sterilization processes, and there is no cure for the disease. The disease may have an incubation period of up to 20 years.

DIF:

1

REF: p. 139

24. To perform chemical tests on bacteria, it is necessary to a. grow them in a laboratory environment b. diffuse them with droplets c. count them under a microscope d. contaminate them with infection

.

ANS: A To perform chemical tests on bacteria, it is necessary to grow them in a laboratory environment. After culturing the bacteria, they can be tested for sensitivity to antimicrobial drugs (culture and sensitivity).

DIF: 25. a. b. c. d.

1

REF: p. 125

causes the greatest number of hospital-acquired infections in the United States.

Insufficient surgical hand scrub Urinary catheterization NURSINGTB.C M O Genetic material Cross contamination

ANS: B The most common hospital-acquired infection is urinary tract infection, usually in patients who have been catheterized.

DIF:

1

REF: p. 144

26. Autoinfection is the spread of infection from one a. prion to a vector b. person to another c. virion to a culture d. part of the body to another location

.

ANS: D If the infection is introduced into one part of the body from another, it is termed self-infection or autoinfection.

DIF:

1

REF: p. 129

27. Staining is a process of coloring microbial specimens so that they can be seen with the . a. optical microscope

SOURCE: Browsegrades.net

b. safety glasses c. naked eye d. surgical site ANS: A Staining is a process of coloring microbial specimens so that they can be seen with the optical microscope.

DIF:

1

REF: p. 126

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Endotoxin b. Exotoxin 1.

2.

3.

4.

5.

6.

7.

8.

Not secreted but released when the cells are disrupted or broken down An example would include pseudomonas and tetanus.

Chemicals contained within the cell wall of bacteria Toxic effect includes fever, increased or decreased number of white blood cells, diarrhea, shock, extreme weakness, or death.

Enters specific body cells and disrupts the cell’s chemical and physical structure When a cell ruptures, this is released into the bloodstream and spreads to different organ systems.

Protein produced as a result of bacterial metabolism N R I G anisms B.COand M excreted outside of the bacterial cell A toxic substance produced bUy mSicroNorgT

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS:

A B A A B A B B

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF:

p. 133 p. 133 p. 133 p. 133 p. 133 p. 133 p. 133 p. 133

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Staphylococcus aureus b. Streptococcus pneumoniae c. Escherichia coli 9. Direct transmission occurs when the gastrointestinal tract is perforated and bowel contents spill into the sterile peritoneal cavity.

10. Most widespread cause of surgical site infections 11. Most frequent cause of urinary tract infection

SOURCE: Browsegrades.net

9. ANS: C 10. ANS: A 11. ANS: B

DIF: DIF: DIF:

3 3 3

REF: p. 134 REF: p. 133 REF: p. 133

SOURCE: Browsegrades.net

Chapter 09: The Principles and Practice of Aseptic Technique Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1.

provide(s) rationales for all the standards and recommendations made by professional organizations in disease transmission, biotechnology, patient safety, and advances in surgical practice. a. Aseptic technique b. Evidence-based practice c. Surgeons d. Surgical assistants ANS: B Evidence-based practice provides rationales for all the standards and recommendations made by professional organizations in disease transmission, biotechnology, patient safety, and advances in surgical practice.

DIF:

2.

2

REF: p. 177

is used in the health care setting for routine hand washing. Plain soap, without antiseptic, is effective in removing soluble fatty acids, soil, and debris from the skin surface. a. Avaguard b. Alcohol foam c. Antiseptic liquid soap d. Living tissue ANS: C Antiseptic liquid soap is used in the health care setting for routine hand washing. Plain soap, without antiseptic, is effective in removing soluble fatty acids, soil, and debris from the skin surface.

DIF:

2

REF: p. 155

3. When used correctly, produce(s) high levels of destruction of both gram-positive and gram-negative bacteria. a. alcohol-based skin cleaner, foams, and creams b. plain soap (liquid or bar) c. germicidal soap d. hot water ANS: A Many studies have demonstrated that, when done properly, the antiseptic hand and arm rub is as effective as the traditional surgical scrub, unless hands or arms are grossly soiled. To be completely effective, all surfaces of the hands and arms must be wet with the antiseptic product. The cidal effect of the product is dependent on the amount of time it is left on the skin, as stated by the manufacturer’s guidelines.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 172

4. Hand washing is the simplest and most important preventive measure for reducing infection in the operating room (OR). Hand washing is . a. time related b. event related c. not necessary if gloves are worn d. only necessary if you come into contact with blood or bodily fluids ANS: B Routine hand washing is an event-related practice (performed before and after a specific task or event). It requires a specific method with individual steps.

DIF:

2

REF: p. 169

5. When supplies and instruments are opened for a case, for safety reasons should be passed directly to the surgical technologist or placed in an area on the sterile field where they are clearly visible. a. sponges b. medications c. scalpel blades and other sharps d. delicate instruments ANS: C Scalpel blades and other sharps should be passed directly to the scrub or unwrapped in an open area where they are in plain view. Blades, trocars, and other sharps should not be opened into instrument trayNs, bR ecaI use G the B sh. arC ps cMan be hidden by other instruments.

U S N T

DIF:

2

O

REF: p. 148

6. Depending on the complexity of the surgery, the amount of equipment to be prepared, and the emergent nature of the procedure, the surgical technologist and the circulator will begin to open the case . a. 15 to 20 minutes before the start of surgery b. at the convenience of the circulator c. as soon as the surgeon is in the room d. as soon as all sterile team members have had a break ANS: A Depending on the complexity of the surgery, the amount of equipment to be prepared, and the degree of emergency, the scrub and the circulator open the case about 15 to 20 minutes before the start of surgery. In extremely large cases, more time may be needed for opening supplies and setting up.

DIF:

2

REF: p. 149

7. The _ is the center of the sterile field during surgery. a. gowned surgeon b. covered back table c. draped patient

SOURCE: Browsegrades.net

d. surgical technologist ANS: C The sterile field is the area covered by sterile drapes. It includes scrubbed personnel who are gowned and gloved. The draped patient is the center of the sterile field.

DIF:

2

REF: p. 149

8. Nonsterile team members sterile goods to the field. a. sometimes b. never c. always d. under certain conditions

lean over or reach over a sterile surface to distribute

ANS: B Nonsterile team members never lean over or reach over a sterile surface to distribute sterile goods to the field. They do not pass between two sterile surfaces.

DIF:

2

REF: p. 150

9. Tables draped with sterile drapes are considered sterile a. 2 inches below the top b. only at table height c. 2 inches from the lower edge of the drape d. only in the center

.

ANS: B Sterile tables are considered sterile only at table height. The top of a sterile table is the only surface considered sterile. Suture ends must not hang over the table edge. Table drapes must not be repositioned once they have been placed, because this changes the level of the sterile area.

DIF:

2

REF: p. 150

10. When sterile supplies have been opened, the setup is vulnerable to contamination. The longer a setup remains exposed, the greater the risk of contamination. It is recommended that supplies not be left open before a case . a. for more than 2 hours b. unless it is constantly monitored for contamination c. unless signs have been posted on the doors, and the doors have been taped to prevent entry into the room d. without informing the patient of the length of time that the room has been open ANS: B When sterile supplies have been opened, the sterile setup is vulnerable to contamination.

Sterile supplies should be opened as close to the time of surgery as possible. In reality, however, cases may be delayed or even canceled. Currently no data are available to suggest that leaving a sterile setup exposed increases the risk of a surgical-site infection. After a room is opened, it must be constantly monitored for contamination. A sterile setup must not be covered because there is no way to remove the drape without risking contamination.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 149

11. When water is exposed to a sterile drape or gown, it can cause , which occurs when moisture from either side of the drape serves as a vehicle for bacteria to infiltrate the drape from the nonsterile surface. a. resident flora b. transient flora c. airborne contamination d. strike-through contamination ANS: D When water comes in contact with a sterile drape or gown, it can cause strike-through contamination. This occurs when moisture from either side of the drape serves as a vehicle for bacteria to infiltrate the drape from the nonsterile surface.

DIF:

2

REF: p. 174

12. Sterile personnel must pass other sterile personnel a. front to front or back to back b. right side to right side c. left side to left side d. right side to left side

.

ANS: A Sterile personnel must pass other sterile personnel back to back or front to front. Even though wraparound gowns are used in most surgical settings, the sterility of the back cannot N rson RSwe INarin GTgB.C M be guaranteed because the peU it canOnot observe it. Sterile personnel never turn their back to the sterile field.

DIF:

2

REF: p. 149

13. Sterile gowns are considered sterile . a. on the entire outside b. in the entire front c. until they get blood or bodily fluids on them d. in the front, from the mid-chest to the table top ANS: D Sterile gowns are considered sterile only in the front from mid-chest to table level. Sterile personnel should not drop their forearms or hands below waist level nor raise them above the mid-chest. The axilla itself is considered nonsterile even though protected by a gown because it is an area of friction.

DIF:

2

REF: p. 153

14. The amount of space that should be left between sterile and nonsterile surfaces is . a. the amount with which the surgical technologist is comfortable b. 12 inches or more

SOURCE: Browsegrades.net

c. the surgeon’s choice—it will be listed on the surgeon’s preference card d. 2 to 4 inches ANS: B Equipment that is not draped must remain outside the sterile field, with at least 12 inches (30 cm) allowed between sterile and nonsterile surfaces.

DIF:

2

REF: p. 150-151

15. Protective goggles, masks, or face shields are required during any procedure in which there is . a. a risk that blood, other body fluids, or particles of tissue could splash on the face b. a nonsterile team member present c. a sign indicating they must be worn d. difficulty in the procedure ANS: A OSHA mandates the use of protective eyewear or face shields as part of its blood-borne pathogen standard to protect workers exposed to splashing by blood and other potentially infectious materials (OPIM). Protective goggles, masks, or face shields are required during any procedure, including endoscopic surgery, in which there is a risk that blood, other body fluids, or particles of tissue could splash on the face.

DIF:

2

REF: p. 148

16. Jewelry of any kind is a potential source of pathogens. The recommended standard is to . a. keep jewelry covered b. only wear earrings and necklaces c. remove all jewelry d. wear only clean jewelry ANS: C The recommended standard issued by all agencies is to remove all jewelry or completely confine it inside scrub clothes. Body piercing jewelry should be confined or removed.

Piercings may contain a bacterial count up to 21 times greater under the jewelry than on the metal itself. A draining or inflamed piercing tract is considered an open infection.

DIF:

2

REF: p. 171

17. The basis of _ is the concept of barriers between contaminated and sterile surfaces. Sterile objects or surfaces are contained or confined to prevent contact with nonsterile objects. a. cross-contamination b. aseptic technique c. continuing education d. teamwork ANS: B

SOURCE: Browsegrades.net

The basis of aseptic technique is the concept of barriers between contaminated and sterile surfaces. Sterile objects or surfaces are contained or confined to prevent contact with nonsterile objects.

DIF:

2

REF: p. 147

18. If water is found in a basin when the sterile wrapper is opened, the basin is considered . a. sterile b. contaminated c. infectious d. contained ANS: B If water is found in a basin when the sterile wrapper is opened, the basin is considered contaminated. This is caused by a problem in steam sterilization, and the central service department must be notified. The load in which the basin was sterilized will be located, and those items will be removed from service.

DIF:

1

REF: p. 148

19. All nonsterile surfaces are considered potentially contaminated with microorganisms. a. strike-through contamination b. pathogenic c. sterile d. chemical ANS: B When an object is sterile, it is completely free of all living microorganisms including microbial spores. All nonsterile surfaces are considered potentially contaminated with pathogenic microorganisms.

DIF:

1

20.

REF: p. 149 infection is a postoperative infection of the surgical wound.

a. b. c. d.

Surgical-site Community-acquired Chemical barrier Physical barrier

ANS: A Surgical-site infection is often the result of contamination of the tissues by microorganisms during the intraoperative period.

DIF:

1

21.

REF: p. 149 provide a barrier between a nonsterile surface and the working area of

the sterile field. a. Sterile drapes

SOURCE: Browsegrades.net

b. Sterilization containers c. Mayo stands d. Antiseptics ANS: A Draped items and sterile personnel form the periphery of the field. Sterile drapes create a barrier between a nonsterile surface and the working area of the sterile field. For example, the operating microscope, ring basin, and back table are draped. Equipment that is not draped must remain outside the sterile field, with at least 12 inches (30 cm) allowed between the sterile and nonsterile surfaces.

DIF:

1

REF: p. 148-149

22. The top of a sterile table is the only part considered sterile. a. and 1 inch down the side b. only c. and bottom d. 3 inches ANS: B The top of a sterile table is the only surface considered sterile. Suture ends must not hang over the table edge. Table drapes must not be repositioned once they have been placed, because this changes the level of the sterile area. Tubing, cords, and hoses that are secured to the patient drape must not be pulled up to create additional slack.

DIF: 23.

1

REF: p. 148

N R I G B.C M

is based on sUurgS icalNconTscienceO : that is, the ethical and professional motivation that regulates a professional’s behaviors regarding disease transmission. a. Evidence-based practice b. Surgical conscience c. Asepsis d. Aseptic technique ANS: D Aseptic technique is based on surgical conscience: that is, the ethical and professional motivation that regulates a professional’s behaviors regarding disease transmission.

DIF:

24.

2

REF: p. 151

is when the surgeon’s gloved hand accidentally touches the nonsterile edge of the surgical drape. a. Contamination b. Surgical conscience c. Asepsis d. Aseptic technique ANS: A Contact between the sterile glove and a nonsterile surface results in contamination of the glove, which must be replaced with a new sterile glove.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 175

25. The is/are worn by both sterile and nonsterile surgical personnel in the perioperative environment. a. scrub suit b. body lotion c. leather shoes d. laboratory coat ANS: A Surgical attire, including scrub suit, head covering, mask, shoes, and jacket, is worn in the restricted and semi-restricted areas of the surgical environment and other areas of the facility where invasive procedures are performed. Scrub suits and cover jackets are manufactured from fabrics that shed little or no lint to prevent bacterial transmission by airborne particles.

DIF:

2

REF: p. 169

26. When removing a contaminated gown during surgery, the scrub should a. have the circulator pull off the gloves b. break the tie on the inside c. have the circulator pull from the shoulders down d. pull from the back

.

ANS: C If the gown is contaminated during surgery, both the gown and gloves must be changed. The contaminated team member steps away from the sterile field to allow the circulator access to the gown. The circulator pulls the gown forward off the shoulders, bundling it inward to N R I G B.C M contain the front, which has bUeenSexpNoseTd to bloOod and body fluids.

DIF:

2

REF: p. 169

27. Before opening a sterile pack, the scrub should also check the outside package for the . a. right size b. integrity c. right wrap d. all the above ANS: B Before opening any sterile pack, always check the integrity of the outside of the package and the external chemical indicators for verification of exposure to the sterilization process.

Any packages with tears, holes, or water marks are contaminated and should be removed from the room for reprocessing and replaced with new packs.

DIF:

2

REF: p. 169

28. What OR furniture should the large pack be placed on before opening? a. Ring stand b. Mayo stand c. Back table

SOURCE: Browsegrades.net

d. Prep stand ANS: C The large pack is opened on the back table, because that is the center of the scrub’s work area.

DIF:

2

REF: p. 170

29. What OR furniture should the instrument tray be placed on before opening? a. Ring stand b. Mayo stand c. Back table d. Small table (prep stand) ANS: D When opening large instrument trays or other heavy equipment, set the tray on a small table and open it in place.

DIF:

2

REF: p. 146

30. What OR furniture should the basin set be placed on before opening? a. Ring stand b. Mayo stand c. Back table d. Prep stand ANS: A Basin sets are placed on a rN inU gR stS anIdNaG ndToB p. enC edOiM n the same manner as large instrument trays. Do not reach over the basin to open it. It is better technique to move around the sterile package and pull flaps toward you.

DIF:

2

REF: p. 147

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Antiseptics b. Asepsis c. Aseptic technique 1.

2.

3.

4.

5.

6.

7.

8.

9.

Chemicals that reduce the number of microorganisms in body tissue or on skin Takes time and practice to develop In surgery, it is a state of the presence of no pathogens Used for the surgical scrub Methods or practices in health care that promote and maintain a state of asepsis “Without infection” The absence of pathogenic microorganisms on an animate surface or on body tissue May prevent recolonization for a limited period Patient skin preparation

SOURCE: Browsegrades.net

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS:

A C B A C B B A A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 146 p. 157 p. 147 p. 146 p. 146 p. 146 p. 148 p. 149 p. 174

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Sterile b. Contaminated 10.

11.

12.

13.

14.

Draped back table top Cuff of gown after donning gloves Armpits Tiny hole in glove Draped patient

10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS:

A B B B A

DIF: 3 REF: p. 164 DIF: 3 REF: p. 164 DIF: 3 REF: p. 148 R I N 3 DIF: U S NGTB.RC EO F:M p. 160 DIF: 3 REF: p. 159

Match each term with the correct definition. You can use answer choices more than once. a. Surgical scrub b. Surgical rub 15.

16.

17.

18.

The application of an approved antiseptic to all surfaces of the hands and fingers Counted strokes Should be used only when no soil is visible on the hands Brushes must be sterile

15. ANS: 16. ANS: 17. ANS: 18. ANS:

B A B A

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 160 p. 159 p. 160 p. 159

SOURCE: Browsegrades.net

Chapter 10: Decontamination, Sterilization, and Disinfection Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Sterile instruments and supplies are loaded onto the transported to the surgical suite. a. case cart b. elevator c. personnel d. conveyor

before surgery and

ANS: A Sterile instruments and supplies are loaded onto the case cart before surgery and transported to the surgical suite.

DIF:

2

2.

REF: p. 184 items must be sterile. These items enter sterile tissue or the vascular

system. a. Semicritical b. Noncritical c. Critical d. Low critical ANS: C Critical items are those that come in contact with sterile body tissues and internal organ systems, including the vascular system. Examples are surgical instruments, vascular cannulas, and hypodermic needles. All medical devices in this category must be sterilized before patient use.

DIF:

2

REF: p. 181

3. Because paper products are difficult or impossible to decontaminate, patient’s charts, x-rays, and laboratory documentation should be . a. left outside of the surgical suite b. kept free from contamination c. flash sterilized d. immediately placed in plastic bags ANS: B Because paper products are difficult or impossible to decontaminate, every effort should be made to keep patients’ charts, laboratory slips, radiograph reports and radiographs, and any paper documentation free of contamination.

DIF:

2

REF: p. 204

SOURCE: Browsegrades.net

4. The phrase flash sterilization has been replaced by sterilization, in which unwrapped surgical equipment is sterilized by a high-vacuum steam sterilization method just before use. a. just-in-time b. quick c. right on time d. immediate-use steam sterilization—IUSS ANS: D Immediate-use steam sterilizer is a high-speed prevacuum sterilizer used in the operating room and in other areas of the hospital to sterilize items for immediate use. Steam sterilization using a short cycle at very high temperature is necessary for sterilization. In the past, the term flash sterilization was used to describe this process. It was determined in 2010 that the term flash sterilization does not reflect the complexity of sterilization for immediate use. The term has been replaced with immediate-use steam sterilization—IUSS. Standards for IUSS have been adapted by professional organizations including AST. DIF: 5.

2

REF: p. 198

is used to sterilize objects that cannot tolerate the heat, moisture, and pressure of steam sterilization. a. Glutaraldehyde solution b. Peracetic acid c. Gas plasma d. Ethylene oxide ANS: D Ethylene oxide is used to sterilize objects that cannot tolerate the heat, moisture, and pressure of steam sterilization.

DIF:

2

REF: p. 198

6. The temperature of the gas directly affects the penetration of items in the chamber.

Operating temperatures range from _ for a “cold” cycle and for a “warm” cycle. a. 85° to 100° F and 130° to 145° F b. 75° to 79° F and 130° to 145° F c. 85° to 100° F and 100° to 125° F d. 85° to 95° F and 100° to 115° F ANS: A The temperature of the gas directly affects the penetration of items in the chamber.

Operating temperatures range from 85° to 100° F for a “cold” cycle and 130° to 145° F for a “warm” cycle.

DIF:

2

REF: p. 203

7. The recommended practice to damp dust the surgical lights, furniture, and fixed equipment in the operating suite is . a. at the end of the day

SOURCE: Browsegrades.net

b. before the beginning of each shift c. before each case of the day d. before the first case of the day ANS: D The recommended practice before the first case of the day is damp dusting of surgical lights, furniture, and fixed equipment in the operating suite. A clean, lint-free cloth and a hospital-grade chemical disinfectant are used.

DIF:

2

REF: p. 188

8. Power-driven surgical instruments (e.g., drills and saws) should be disassembled before . a. using them b. semicritical cleaning c. noncritical cleaning d. steam sterilization ANS: D Power-driven surgical instruments (e.g., drills and saws) should be disassembled before sterilization. Hoses can be coiled loosely during packaging, and all delicate switches and parts should be protected during preparation.

DIF:

2

REF: p. 185

9. The ultrasonic cleaner removes debris from instruments by a process called a. cavitation b. agitation c. osculation d. both A and B

.

ANS: A The ultrasonic cleaner removes debris from instruments by a process called cavitation.

High-frequency sound waves are generated through a water bath. Cavitation causes tiny air spaces trapped within debris to implode (explode inwardly), and this releases the debris from the surface of the instrument.

DIF:

2

REF: p. 193

10. A is a paper strip or specially treated tape that changes color when exposed to a specific temperature. a. wrapping paper b. litmus paper c. paper monitor d. chemical indicator ANS: D A chemical indicator (monitor) is a chemically treated strip that changes color when exposed to a specific temperature, pressure, and humidity.

DIF:

2

REF: p. 182

SOURCE: Browsegrades.net

11. The purpose of wrapping an item before sterilization is to protect it from after the sterilization process. a. light b. damage c. infection d. contamination ANS: D The purpose of wrapping an item before sterilization is to protect it from contamination after the sterilization process. Two broad categories of wrappers are woven and nonwoven paper or polymer material. Combination polypropylene-paper pouches are also used to wrap items before sterilization.

DIF:

2

REF: p. 181-182

12. The Spaulding classification of reprocessing instruments and patient materials assigns three risk levels based on the specific region of the body where the device will be used. These levels are critical, semicritical, and . a. noncritical b. uncritical c. ultra-critical d. low-critical ANS: A The Spaulding category associates high risk with critical devices. Intermediate risk is assigned to semicritical devNiceR s, anId loGw-rBis. kC devM ices are noncritical.

U S N T

DIF:

2

O

REF: p. 195

13. Which class includes indicators that are the most exacting and accurate of all indicators and that react to all critical values over a specified range in the sterilization process? a. 5 b. 4 c. 3 d. 2 ANS: A Class 5 (integrating parameters) includes indicators that react to all critical values over a specified range in the sterilization process. These are the most exacting and accurate of all indicators.

DIF:

2

REF: p. 195

14. Which class includes indicators that respond to only one critical parameter with an exact value? a. 2 b. 5 c. 1 d. 3

SOURCE: Browsegrades.net

ANS: D Class 3 (single parameter) includes indicators that respond to only one critical parameter with an exact value. An example is a heat-sensitive pellet (encased in a glass tube) that melts only at a certain temperature that is consistent with the sterilization method. The pellet is placed in specific areas of the sterilization chamber.

DIF:

2

REF: p. 195

15. Class indicators are used for internal pack control of each cycle run, not for the overall performance of the sterilizer for all cycles. a. 2 b. 6 c. 4 d. 5 ANS: B Class 6 indicators (emulating indicators) are used for internal pack control of each cycle run, not for the overall performance of the sterilizer for all cycles.

DIF:

2

REF: p. 195

16. Class indicators measure parameters. Examples include the Bowie-Dick and daily air-removal tests for the presence of pure air (no steam) in the sterilization chamber. a. 4 b. 2 c. G d. L ANS: B Class 2 (specialty indicators) are used for specific tests that measure parameters. Examples include the Bowie-Dick and daily air-removal tests for the presence of pure air (no steam) in the sterilization chamber.

DIF:

1

REF: p. 195

17. Class is represented by multivariable indicators that react to two or more parameters. An example is internal chemical indicators printed on a paper strip. a. 4 b. 2 c. L d. G ANS: A Class 4 (multiparameter) is represented by multivariable indicators that react to two or more parameters. An example is internal chemical indicators printed on a paper strip.

DIF:

1

REF: p. 194

18. There are three distinct phases in all types of steam sterilizers. removed from the chamber and replaced with steam.

SOURCE: Browsegrades.net

is when air is

a. b. c. d.

Conditioning Exposure Parameter Indication

ANS: A The phase of steam sterilization when air is removed from the chamber and replaced with steam is called conditioning (sometimes called preconditioning).

DIF:

1

REF: p. 194

19. Two types of steam sterilizers are used in the clinical setting: a. gravity displacement and Sterrad b. gravity displacement and dynamic c. dynamic and internal d. preconditioned and unconditioned

.

ANS: B Two types of steam sterilizers are used in the clinical setting: gravity displacement and dynamic (also called prevacuum or high-vacuum sterilizers).

DIF:

1

REF: p. 194

20. The sterilizer operates on the principle that air is heavier than steam. a. dynamic b. gravity displacement c. unconditioned d. preconditioned ANS: B The gravity displacement sterilizer (also called a downward displacement sterilizer) operates on the principle that air is heavier than steam. All the air must be removed from the inner chamber, because all surfaces of the items must be exposed to the pressurized steam to ensure sterilization. Any air in the inner chamber blocks the passage of pressurized steam to the goods and prevents sterilization. The sterilizer is constructed in such a way that air is displaced downward by gravity (hence the name gravity displacement sterilizer) and is replaced by steam.

DIF:

1

REF: p. 194

21. The sterilizer pulls air from the chamber with vacuum force and replaces it with steam. As air is pumped into the chamber, steam enters in pulsed phases. Air is completely removed with positive and negative pressure pulses. As the pressure increases, so does the temperature of the steam inside the sterilizer. a. dynamic air-removal (prevacuum) b. gravity displacement c. unconditioned d. preconditioned ANS: A

SOURCE: Browsegrades.net

The dynamic air-removal (prevacuum) sterilizer pulls air from the chamber with vacuum force and replaces it with steam. As air is pumped into the chamber, steam enters in pulsed phases. Air is completely removed with positive and negative pressure pulses. As the pressure increases, so does the temperature of the steam inside the sterilizer.

DIF:

1

REF: p. 192

22. The important factor to remember about is that they do not indicate sterility, only that certain conditions for sterility have been met. a. indicators b. Bowie-Dick tests c. detergents d. case cart systems ANS: A A chemical indicator (monitor) is a chemically treated strip that changes color when exposed to a specific temperature, pressure, and humidity. The pellet form of this indicator is contained in a glass vial. Chemical monitors are available for both steam and EO sterilization. The chemical responds to high temperature, pressure, and humidity but does not register exposure time, which is critical to the sterilization process. A chemical monitor should be placed inside and outside all packs to be sterilized. After the cycle, the indicator must be retrieved and interpreted.

DIF: 23.

1

REF: p. 182-183

is a skilled, certified profession that requires expertise in the science and practice of materials managNem ent, UR SIdec NGonta TBm.inCatio OMn, and sterilization. a. Certified Surgical Technologists b. Sterile Processing Technicians c. Enzymatic cleaner d. High vacuum sterilizer ANS: B The personnel responsible for this are the Sterile Processing Technicians (SPTs). This is a skilled, certified professional that requires expertise in the science and practice of materials management, decontamination, and sterilization.

DIF:

1

REF: p. 182

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Critical items b. Semicritical items c. Noncritical items 1. Stethoscopes, blood pressure, and tourniquet cuffs 2. Exposed to the skin but not mucous membranes 3. Objects that enter sterile tissue or the vascular system

SOURCE: Browsegrades.net

4.

5.

6.

7.

8.

9.

10.

Laryngoscopes, bronchoscopes, and endotracheal tubes Must be sterile Can include bed linens, crutches, tables Come into contact with mucous membranes or nonintact skin Include vascular and urinary catheters Not required to be sterile because they do not penetrate intact tissues Must be sterilized before use on a patient

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS:

C C A B A C B A C A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 182 p. 181 p. 181 p. 181 p. 182 p. 181 p. 182 p. 181 p. 182 p. 188

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Decontamination b. Disinfection c. Sterilization 11.

12.

13.

14.

15.

16.

17.

Used for noncritical items Uses steam, ethylene oxide, peracetic acid, or cobalt-60 Process by which all microorganisms, including spores, are destroyed Uses isopropyl alcohol 70% to 90%, glutaraldehyde, and iodophor solution Used for anesthesia equipment, gastrointestinal endoscopes, bronchoscopes Monitored by chemical and biological methods to ensure patient safety Used for surgical instruments, implants, and needles

11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS:

B C C B B C C

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF:

p. 180 p. 202 p. 181 p. 192 p. 181 p. 180 p. 181

SOURCE: Browsegrades.net

Chapter 11: Surgical Instruments Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The hinge point of many surgical instruments is called the a. clamp b. points c. shank d. box lock

.

ANS: D Box lock is the hinge point of many surgical instruments.

DIF:

2

2. A McPherson a. handheld b. superficial c. malleable d. self-retaining

REF: p. 225 lid speculum is used to retract the eyelids.

ANS: D A McPherson self-retaining lid speculum is used to retract the eyelids.

DIF:

2

G B.C M U S N T O

REFN : pR . 21I 4

3. A is used to cut and extract tissue and is distinguished by having a spring-loaded hinge. a. retractor b. clamp c. forcep d. rongeur ANS: D A rongeur is used to cut and extract tissue and is distinguished by having a spring-loaded hinge.

DIF:

2

REF: p. 209

4. Fibrous connective tissue requires heavy scissors, such as the a. curved Mayo b. Metzenbaum c. Stevens tenotomy d. Castroviejo

scissors for cutting.

ANS: A Fibrous connective tissue requires heavier scissors, such as the curved Mayo scissors.

DIF:

2

REF: p. 209

SOURCE: Browsegrades.net

5.

blades and handles are smaller and more delicate than those used in general surgery. a. Beaver b. Number 4 c. Amputation d. Smillie ANS: A Beaver blades and handles are smaller and more delicate than those used in general surgery.

DIF:

2

REF: p. 208

6. A(n) blade is detachable from the knife handle, although single-use scalpels are available and these do not detach. a. scalpel b. electrocautery c. Metzenbaum d. harmonic ANS: A A scalpel blade is detachable from the knife handle, although single-use scalpels are available and these do not detach.

DIF:

2

REF: p. 208

7. The Babcock clamp is an aN trauR matI ic, nGoncBru.sC hingMclamp used to manipulate the bowel U S N T O or tubes. a. fallopian b. intestinal c. kocher d. tissue ANS: A The Babcock clamp is an atraumatic, noncrushing clamp used to manipulate the bowel or fallopian tubes.

DIF:

2

REF: p. 220

8. Although almost all and other bone cutting instruments are powered pneumatically, one unpowered type is still commonly used during amputation. a. grasps b. saws c. tools d. rigids ANS: B Although almost all saws and other bone cutting instruments are powered pneumatically, one unpowered type is still commonly used during amputation.

DIF:

2

REF: p. 210

SOURCE: Browsegrades.net

9. Strong dissecting scissors such as curved tendons. a. Metzenbaum b. bandage c. Mayo d. tenotomy

scissors are used on fascia and large

ANS: C Strong dissecting scissors such as curved Mayo scissors are used on fascia and large tendons.

DIF:

2

10. The bone. a. rigid b. drape c. handler d. Gigli

REF: p. 221 is used by mounting its ends on hook handles and drawing it through the

ANS: D The Gigli is used by mounting its ends on hook handles and drawing it through the bone.

DIF:

2

REF: p. 210-211

11. Toothed are usedNfoR r sutI urinGg aB di. poCse tM issue.

U S N T O a. specula b. needle holders c. forceps d. clamps ANS: C Toothed forceps are used for suturing adipose tissue.

DIF:

2

REF: p. 219

12. The , which has a T tip with fine serrations at the tip, often is used to clamp or grasp adipose tissue. a. Doyen b. Satinsky c. Allis clamp d. bulldog ANS: C The Allis clamp, which has a T tip with fine serrations at the tip, often is used to clamp or grasp adipose tissue.

DIF:

2

13. The term

REF: p. 219 can refer to any instrument that closes over tissue to hold or occlude it.

SOURCE: Browsegrades.net

a. b. c. d.

necrotic adipose histology clamp

ANS: D The term clamp can refer to any instrument that closes over tissue to hold or occlude it.

DIF:

2

14. Skin is a. semisolid b. elastic c. boggy d. intestinal

REF: p. 211 , relatively fibrous, and strong.

ANS: B Skin is elastic, relatively fibrous, and strong.

DIF:

2

REF: p. 219

15. The carbide inserts in needle holders prevent the needle from slipping or rotating. a. ebonizing b. diamond c. chromium d. tungsten ANS: D The tungsten carbide inserts in needle holders prevent the needle from slipping or rotating.

DIF:

2

REF: p. 207

16. Only partially clamps and smooth tissue forceps are used in the lungs, spleen, liver, or thyroid. a. occluding b. atraumatic c. single-action rongeur d. double-action rongeur ANS: A Only partially occluding clamps and smooth tissue forceps are used in the lungs, spleen, liver, or thyroid.

DIF:

2

REF: p. 219

17. Fine are used in ear, nose, and throat surgery for the delicate bones and surfaces of the nasal sinuses and ear. a. rasps b. osteotomes c. chisels d. anvils

SOURCE: Browsegrades.net

ANS: A Fine rasps are used in ear, nose, and throat surgery for the delicate bones and surfaces of the nasal sinuses and ear.

DIF: 18. a. b. c. d.

2

REF: p. 210

are available in many widths and sizes that fit a particular specialty.

Tools Chisels Tubular structures Alloys

ANS: B Chisels are available in many widths and sizes that fit a particular specialty.

DIF:

2

19. The structure. a. dilator b. curette c. chisel d. stricture

REF: p. 210 is a cylindrical instrument used to increase the inside diameter of a tubular

ANS: A The dilator is a cylindrical instrument used to increase the inside diameter of a tubular structure.

DIF:

2

REF: p. 216

20. The cutting assembly includes a(n) cartridge. a. anvil b. probe c. gouge d. anastomosis

, which clamps the tissue against the staple

ANS: A The cutting assembly includes an anvil, which clamps the tissue against the staple cartridge.

DIF:

2

REF: p. 215

21. If we examine some common design/function relationships in instruments, it clarifies understanding of instrument as a whole. a. technology b. design c. color d. diameter ANS: A

SOURCE: Browsegrades.net

If we examine some common design/function relationships in instruments, it clarifies understanding of instrument technology as a whole.

DIF:

2

REF: p. 206

22. A is used to cut and extract tissue and is distinguished by having a spring-loaded hinge. a. rongeur b. transector c. Babcock d. ratchet ANS: A A rongeur is used to cut and extract tissue and is distinguished by having a spring-loaded hinge.

DIF:

2

REF: p. 209

23. A partial or atraumatic clamp has locking ratchets, but the tips and shanks do not close tightly over the tissue. a. occlusion b. smooth c. rough d. hinge ANS: A A partial occlusion or atrauN matR ic cI lamG p haBs . loC ckinMg ratchets, but the tips and shanks do not O close tightly over the tissue. U S N T DIF:

2

REF: p. 212

24. A is a graduated, smooth instrument used to increase the diameter of an anatomical opening in tissue. a. clamp b. dilator c. anvil d. ratchet ANS: B A dilator is a graduated, smooth instrument used to increase the diameter of an anatomical opening in tissue.

DIF:

2

REF: p. 216

25. A is a grasping instrument with sharp pointed tips, generally used to manipulate or grasp tissue such as the thyroid or cervix. a. tenaculum b. Babcock c. Kelly d. Lowman

SOURCE: Browsegrades.net

ANS: A A tenaculum is a grasping instrument with sharp, pointed tips, generally used to manipulate or grasp tissue such as the thyroid or cervix.

DIF:

2

REF: p. 212-213

26. Suction (aspiration) is needed during a surgical procedure to clear blood, fluids, and small bits of tissue debris from the surgical site and provide an unobstructed view of the . a. poole b. fossil c. backside d. anatomy ANS: D Suction (aspiration) is needed during a surgical procedure to clear blood, fluids, and small bits of tissue debris from the surgical site and provide an unobstructed view of the anatomy.

DIF:

2

REF: p. 214-215

27. The center screw of the a. scissors b. Mayo c. railing d. straightener

can become worn with time.

ANS: A The center screw of the scissors can become worn with time.

DIF:

2

REF: p. 225

28. The Babcock clamp is a(n) fallopian tubes. a. atraumatic b. grasping c. retracting d. cutting

, noncrushing clamp used to manipulate the bowel or

ANS: A The Babcock clamp is an atraumatic, noncrushing clamp used to manipulate the bowel or fallopian tubes.

DIF: 29. A a. b. c. d.

2

REF: p. 213

has one or more needle-sharp teeth in jaws that can be delicate or heavy. retractor clamp forcep tenaculum

ANS: D

SOURCE: Browsegrades.net

A tenaculum has one or more needle-sharp teeth in jaws that can be delicate or heavy.

DIF:

2

REF: p. 212-213

30. The Heaney clamp is used specifically in a. orthopedic b. general c. urological d. gynecological

_ surgery to grasp the uterine ligaments.

ANS: D The Heaney clamp is used specifically in gynecological surgery to grasp the uterine ligaments.

DIF:

2

REF: p. 212

31. By definition, the selfretractor works by a ratchet or other locking mechanism to hold the retractor blades in place in the surgical wound. a. steering b. retaining c. retracting d. closing ANS: B By definition, the self-retaining retractor works by a ratchet or other locking mechanism to hold the retractor blades in place in the surgical wound.

DIF: 32. a. b. c. d.

2

N R I G B.COM

REF: Up. 2S14N T

reduces glare but is also prone to staining.

Highly polished or mirror finish Satin finish Black chromium Satin finish

ANS: D Satin finish reduces glare but is also prone to staining.

DIF: 33. a. b. c. d.

2

REF: p. 207

instruments resist staining.

Highly polished or mirror finish Satin finish Black chromium Titanium anodizing

ANS: A Highly polished or mirror finish instruments resist staining.

DIF:

2

REF: p. 207

SOURCE: Browsegrades.net

34. a. b. c. d.

is a method that imparts color and hardness to the surface of titanium.

Highly polished or mirror finish Satin finish Black chromium Titanium anodizing

ANS: D Titanium anodizing is a method that imparts color and hardness to the surface of titanium.

DIF: 35. a. b. c. d.

2

REF: p. 207

finish is used on laser surgery instruments.

Highly polished or mirror Satin Black chromium Titanium anodizing

ANS: C Black chromium finish is used on laser surgery instruments.

DIF:

2

36. The handle. a. rongeur b. osteotome c. curette d. shears

REF: p. 207 is a small cup with a sharpened, serrated, or smooth rim at the end of the

ANS: C The curette is a small cup with a sharpened, serrated, or smooth rim at the end of the handle.

DIF:

2

REF: p. 210

37. A(n) is a V-shaped bone chisel. a. rongeur b. osteotome c. curette d. gouge ANS: D A gouge is a V-shaped bone chisel.

DIF:

2

38. A(n) a. rasp b. curette c. chisel d. osteotome

REF: p. 206 is used to remodel bone.

SOURCE: Browsegrades.net

ANS: A A rasp is used to remodel bone.

DIF:

2

REF: p. 210

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Grasping and holding b. Cutting and dissecting c. Retracting or exposing 1. Scalpel blades are numbered consistently among manufacturers, and the number indicates their shape and size.

2. Holds tissue against the walls of the surgical wound by mechanical action 3. During suturing, the surgeon will use this in one hand and the needle holder with the suture in the other.

4. The tenaculum contains one or more teeth in the jaws that can be delicate or heavy.

5. Thompson, Bookwalter, and Balfour 6. Kocher and Babcock 7. Beaver handle, commonly used in eye and ear surgery 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS:

B C A A C A B

DIF: 3 REF: p. 208 DIF: 3 REF: p. 214 DIF:NU3RSINGTB.RC EO F:M p. 212 DIF: 3 REF: p. 212 DIF: 3 REF: p. 214 DIF: 3 REF: p. 212-213 DIF: 3 REF: p. 208

SOURCE: Browsegrades.net

Chapter 12: Perioperative Pharmacology Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. a. b. c. d.

is used for augmentation of labor.

Epinephrine Acetic acid Lugol’s solution Oxytocin

ANS: D Oxytocin is used for augmentation of labor.

DIF: 2. a. b. c. d.

2

REF: p. 265

stimulate the production of urine by the kidneys.

Ophthalmic drugs Colloids Diuretics Contrast mediums

ANS: C Diuretics stimulate the production of urine by the kidneys.

DIF:

2

G B.C M U S N T O

REFN : pR . 26I 4

3. Colored dyes are usually dispensed to the sterile field in glass vials. The most common types are gentian violet, methylene blue, and . a. indigo carmine b. color codes c. abnormal shades d. performers ANS: A Colored dyes are usually dispensed to the sterile field in glass vials. The most common types are gentian violet, methylene blue, and indigo carmine.

DIF:

2

REF: p. 258

4. A(n) is a drug that inhibits blood clot formation but does not dissolve clots. a. hemostatic agent b. absorbable collagen c. anticoagulant d. antineoplastic agent ANS: C An anticoagulant is a drug that inhibits blood clot formation but does not dissolve clots.

DIF:

2

REF: p. 254

SOURCE: Browsegrades.net

5. Angina, which is chest pain associated with decreased oxygen supply to the heart muscle, is partly treated using drugs. a. antianginal b. osmotic c. aminoglycosides d. antimicrobials ANS: A Antianginal drugs are used to treat angina, which is chest pain associated with decreased oxygen supply to the heart muscle.

DIF:

2

REF: p. 264

6. Knowledge of nerve transmission is basic to an understanding of how anesthetics and other drugs work. a. CNN b. CBS c. ABC d. CNS ANS: D Knowledge of nerve transmission is basic to an understanding of how anesthetics and other CNS drugs work.

DIF:

2

REF: p. 254

N R I G B.CObMlood vessels or near open blood vessels.

7. Only intravenous solutions aU re uS sed N to T a. produce b. irrigate c. contrast d. direct

ANS: B Only intravenous solutions are used to irrigate blood vessels or near open blood vessels.

DIF: 8. A a. b. c. d.

2

REF: p. 261

tablet is placed between the gum and mucous membrane of the cheek. buccal topical oral sublingual

ANS: A A buccal tablet is placed between the gum and mucous membrane of the cheek.

DIF:

2

9. Exogenous of action.

REF: p. 247 for injection is available in different strengths and differing duration

SOURCE: Browsegrades.net

a. b. c. d.

tuberculin Luer-Lok insulin catheter tip

ANS: C Exogenous insulin for injection is available in different strengths and differing duration of action.

DIF:

2

REF: p. 265

10. The movement of a drug through the tissues and cells of the body, including the processes of absorption, distribution, and localization in tissues; biotransformation; and excretion by mechanical or chemical means is called . a. pharmacodynamics b. pharmacokinetics c. metabolism d. absorption ANS: B The movement of a drug through the tissues and cells of the body, including the processes of absorption, distribution, and localization in tissues; biotransformation; and excretion by mechanical or chemical means is called pharmacokinetics.

DIF:

2

REF: p. 229

11. Drug delivery devices suchNas R I G aB re.cC alibM rated in small increments to provide a high U S N T O level of accuracy. a. calibrated cups b. syringes c. calibrated basins d. spoons ANS: B Drug delivery devices such as syringes are calibrated in small increments to provide a high level of accuracy.

DIF:

2

REF: p. 238

12. A drug applied to the skin or mucous membranes is a. subcutaneous b. parenteral c. topical d. instill

.

ANS: C Topical refers to application of a drug to the skin or mucous membranes.

DIF:

2

REF: p. 247

SOURCE: Browsegrades.net

13. To reduce drug error when drugs are being used in the sterile field, each and every drug container and its delivery device must be . a. used only once b. closely watched by the surgeon c. sealed d. labeled ANS: D All pharmaceutical products, including implants, are labeled with specific information mandated by the U.S. Food and Drug Administration.

DIF:

2

REF: p. 245

14. The is the one that has been ordered by the surgeon or other health care provider. a. concentration b. right drug c. wrong drug d. type ANS: B The right drug is the one that has been ordered by the surgeon or other health care provider.

DIF:

2

REF: p. 248

15. The identifies a drug by its molecular structure. a. generic name b. drug nomenclature c. trade name d. chemical name ANS: D The chemical name is the name of a drug that reflects its molecular structure.

DIF: 16.

2

REF: p. 232

is an undesirable or intolerable reaction to a drug administered at the normal dosage. a. Toxicity b. A side effect c. An adverse reaction d. Anaphylaxis ANS: C An adverse reaction is an undesirable or intolerable reaction to a drug administered at the normal dosage.

DIF:

2

REF: p. 247

17. After of a drug, the patient is assessed for physiological changes, including adverse reactions. a. absorption

SOURCE: Browsegrades.net

b. metabolism c. elimination d. administration ANS: D After administration of a drug, the patient is assessed for physiological changes, including adverse reactions.

DIF:

2

REF: p. 247

18. Changes (both intended and unintended) in the body as a result of a drug are called . a. pharmacokinetics b. pharmacodynamics c. physiodynamics d. physiokinetics ANS: B Changes (both intended and unintended) in the body as a result of a drug are called pharmacodynamics.

DIF: 19.

1

REF: p. 235

is the study of movement of drugs through the body (what the body does to the drug). a. Pharmacokinetics b. Pharmacodynamics c. Physiodynamics d. Physiokinetics ANS: A Pharmacokinetics is the study of movement of drugs through the body (what the body does to the drug).

DIF:

2

REF: p. 234

20. Drugs are eliminated or cleared from the body mainly through the a. lungs b. kidneys c. skin d. heart

.

ANS: B Drugs are eliminated or cleared from the body mainly through the kidneys.

DIF:

2

REF: p. 235

21. The is required to handle and deliver a number of different categories of drugs used on the sterile field. a. anesthesia provider b. surgical technologist

SOURCE: Browsegrades.net

c. contrast medium d. apothecary ANS: B The surgical technologist is required to handle and deliver a number of different categories of drugs used on the sterile field.

DIF:

2

REF: p. 250

22. The is a clear, injectable liquid that is radiopaque (opaque on radiographs). a. iodinated contrast medium b. diagnostic dye c. intrathecal d. topical ANS: A An iodinated contrast medium (ICM) is a clear, injectable liquid that is radiopaque (opaque on radiographs).

DIF:

2

REF: p. 258

23. A(n) is used as a diagnostic tool to differentiate normal cells from abnormal ones. a. milliliter b. stain c. number system d. irrigation ANS: B A stain is used as a diagnostic tool to differentiate normal cells from abnormal ones.

DIF:

2

REF: p. 258

24. Irrigation solutions are maintained at body temperature to prevent a. hypothermia b. sickness c. waste d. excess

_.

ANS: A Irrigation solutions are maintained at body temperature to prevent hypothermia.

DIF:

2

REF: p. 243

25. The most extreme form of a. uterotropics b. pitressin c. sensitivity d. isoproterenol

is anaphylactic shock, which can lead to death.

ANS: C The most extreme form of sensitivity is anaphylactic shock, which can lead to death.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 247

26. The has/have developed a list of abbreviations that can lead to drug errors. a. agents b. drug administration c. medical offices d. Joint Commission ANS: D The Joint Commission has developed a list of abbreviations that can lead to drug errors.

DIF:

2

REF: p. 249

27. The patient may be started on postoperative infection. a. scheduled b. intravenous c. solid d. liquid

antibiotics a few hours before surgery, to prevent

ANS: B The patient may be started on intravenous antibiotics a few hours before surgery, to prevent postoperative infection.

DIF:

2

REF: p. 258

N R I G B.COM .

28. Penicillin was developed durU ing S the N earlT y a. 1940s b. 1950s c. 1960s d. 1970s

ANS: A Penicillin was developed during the early 1940s.

DIF:

2

REF: p. 259

29. Macrolides are a. stimulant b. liquidity c. bacteriostatic d. chemicals

at low levels and bactericidal in high doses.

ANS: C Macrolides are bacteriostatic at low levels and bactericidal in high doses.

DIF:

2

30.

REF: p. 259 is/are effective against gram-negative bacteria, in which they inhibit protein

synthesis.

SOURCE: Browsegrades.net

a. b. c. d.

Aminoglycosides Ancef Transdermal Heparin

ANS: A Aminoglycosides are effective against gram-negative bacteria, in which they inhibit protein synthesis.

DIF:

2

REF: p. 259

31. Whole blood contains serum and blood cells plus anticoagulant and a. gelfoam b. preservative c. thrombin d. bone wax

.

ANS: B Whole blood contains serum and blood cells plus anticoagulant and preservative.

DIF:

2

REF: p. 251

32. One method of blocking is to administer a competitive antagonist drug that has an affinity for the postsynaptic receptor. a. absorption b. distribution c. metabolism d. neurotransmission ANS: D One method of blocking neurotransmission is to administer a competitive antagonist drug that has an affinity for the postsynaptic receptor.

DIF: 33.

2

REF: p. 255

is/are among the most common drugs used for moderate and severe pain control. a. Peaks b. Distribution c. Opiates d. Metabolism ANS: C Opiates are among the most common drugs used for moderate and severe pain control.

DIF:

2

REF: p. 256

34. True allergy to a drug is mediated by the a. immune system b. cooling system c. liquid system

.

SOURCE: Browsegrades.net

d. allergy system ANS: A True allergy to a drug is mediated by the immune system and requires previous exposure to substances in the drug or a genetic predisposition to allergy.

DIF:

2

REF: p. 247

35. Antifungal drugs are used for a. anaphylactic b. superficial c. antibiotics d. tuberculin

and systemic fungal disease.

ANS: B Antifungal drugs are used for superficial and systemic fungal disease.

DIF:

2

REF: p. 259

36. Antacids reduce gastric fluid a. patients b. acidity c. diabetes d. adolescents

and volume.

ANS: B Antacids reduce gastric fluid acidity and volume.

DIF:

2

REF: p. 264

37. A specific protocol (method) is used to receive and deliver drugs to the a. bleeding b. hemorrhage c. closure d. sterile

field.

ANS: D A specific protocol (method) is used to receive and deliver drugs to the sterile field.

DIF:

2

REF: p. 266

38. One of the most common sources of drug error is failure to properly label syringes and other drug devices. a. delivery b. routine c. traveler d. ringer ANS: A One of the most common sources of drug error is failure to properly label syringes and other drug delivery devices.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 245

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Side effects b. Adverse reactions c. Toxicity 1.

2.

3.

4.

An undesirable or intolerable reaction to a drug administered at the normal dosage Occurs when the therapeutic dosage of a drug is exceeded Not expected but may be predictable in some individuals Patients who are prescribed drugs with a narrow therapeutic range are tested at regular intervals for blood levels of the drug to prevent this

1. ANS: 2. ANS: 3. ANS: 4. ANS:

B C B C

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 247 p. 235 p. 247 p. 235

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Antibiotic ntURSINGTB.COM b. Diagnostic imaging ageN c. Hemostatic d. Anticoagulant 5.

6.

7.

8.

9.

10.

Bacitracin Used to prevent postoperative wound infections Used as a direct topical application to areas of active bleeding to control the bleeding Heparin Gelfoam Thrombin

5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS:

A A C D C C

DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3

REF: REF: REF: REF: REF: REF:

p. 258 p. 258 p. 252 p. 254 p. 252 p. 252

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Parenteral b. Oral c. Topical

SOURCE: Browsegrades.net

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

Sublingual Intravenous Vaginal Intraosseous (IO) Subcutaneous (SQ) Intradermal (ID) Transdermal Intraperitoneal Ingestion Inhalant Intramuscular (IM) Instillation Rectal Buccal Nasal Intraspinal

11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS: 18. ANS: 19. ANS: 20. ANS: 21. ANS: 22. ANS: 23. ANS: 24. ANS: 25. ANS: 26. ANS:

B A C A A A C A B C A C C B C A

DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF:N 3 R EF: p. 247 R I G B. C M U S N T DIF: 3 REO F: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247 DIF: 3 REF: p. 247

SOURCE: Browsegrades.net

Chapter 13: Anesthesia and Physiological Monitoring Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1.

measures the electrical activity of the heart, which is projected into a waveform. a. Electrocardiography (ECG) b. Temperature monitoring c. Neuromuscular monitoring d. Electroencephalogram ANS: A ECG measures the electrical activity of the heart, which is projected into a waveform.

DIF:

2.

2

REF: p. 275

is a digital sensor that detects oxygen saturation in the hemoglobin by spectrometry. a. Capnography b. Vascular monitoring c. Pulse oximeter d. Temperature monitoring ANS: C The pulse oximeter is a digN ital R senI sor tG hatB de.teCctsM oxygen saturation in the hemoglobin by spectrometry.

DIF:

2

U S N T

O

REF: p. 275

3. Laryngospasm constitutes an emergency when an airway cannot be immediately established by ventilation. a. positive-pressure b. spontaneous c. full oxygen d. reversal ANS: A Laryngospasm constitutes an emergency when an airway cannot be immediately established by positive-pressure ventilation.

DIF:

2

REF: p. 290

4. Administering requires that the AP administer sedative and anxiolytic (antianxiety) drugs as needed and manage any anesthetic or physiological emergencies. a. general anesthesia care b. monitored anesthesia care (MAC) c. anxiolysis

SOURCE: Browsegrades.net

d. homeostasis ANS: B MAC is continuous patient monitoring provided during regional anesthesia. In addition to physiological monitoring, the ACP administers sedative and anxiolytic (antianxiety) drugs as needed and manages any anesthetic or physiological emergencies.

DIF: 5.

2

REF: p. 286

anesthesia is the injection of anesthetic into superficial tissues to produce a small area of anesthesia. a. Local infiltration b. Regional infiltration c. General d. Saddle block ANS: A Local infiltration is injection of an anesthetic into superficial tissues to produce a small area of anesthesia.

DIF:

2

REF: p. 286

6. Spasm of the larynx usually is associated with airway secretions or stimulation of the laryngeal nerve during intubation or . a. administration b. induction c. extubation d. amnesia ANS: C Spasm of the larynx usually is associated with airway secretions or stimulation of the laryngeal nerve during intubation or extubation.

DIF:

2

REF: p. 290

7. Adequate is necessary during general anesthesia to manipulate the body wall and other tissues within the operative site. a. cardiac relaxation b. local anesthesia c. personnel d. muscle relaxation ANS: D Without adequate muscle relaxation or paralysis, retraction of the body wall and other tissues is difficult, and this prevents adequate exposure of the operative site.

DIF:

2

REF: p. 285

8. Termination of anesthesia and the process of regaining consciousness are called . a. conclusion

SOURCE: Browsegrades.net

b. ending c. waking d. emergence ANS: D Termination of anesthesia and the process of regaining consciousness are called emergence.

DIF:

2

REF: p. 285

9. A is a type of anesthesia in a specific area of the body by injection of anesthetic around a major nerve or group of nerves. a. topical anxiolytic b. topical anesthetic c. peripheral nerve block d. regional block ANS: D Regional block is anesthesia in a specific area of the body, achieved by injection of an anesthetic around a major nerve or group of nerves.

DIF: 10.

2

REF: p. 269

anesthesia can be used in a small, superficial area of skin and subcutaneous tissue or in an entire region of the body, such as during spinal anesthesia. a. Regional b. Epidural c. Continuous d. Nerve ANS: A Regional anesthesia can be used in a small, superficial area of skin and subcutaneous tissue or in an entire region of the body, such as during spinal anesthesia.

DIF:

11. a. b. c. d.

2

REF: p. 285-286

is a state in which the patient can respond to verbal commands.

Thoracotomy Performance Minimal sedation Administer resuscitative

ANS: C Minimal sedation is a state in which the patient can respond to verbal commands.

DIF: 12.

2

REF: p. 285

anesthesia is induced with the drug ketamine, which blocks sensory neurotransmission and associative pathways. a. Sedation b. Regional c. General

SOURCE: Browsegrades.net

d. Dissociative ANS: D Dissociative anesthesia is induced with the drug ketamine, which blocks sensory neurotransmission and associative pathways.

DIF: 13.

2

REF: p. 285

sedation is used for short diagnostic and minor surgical procedures that do not require deep anesthesia. a. Local b. Regional c. Saddle d. Conscious ANS: D Conscious sedation is used for short diagnostic and minor surgical procedures that do not require deep anesthesia.

DIF:

14.

2

REF: p. 285

is treated with mechanical ventilation or, in severe cases, administration of succinylcholine to paralyze the muscles. a. Pancuronium b. Laryngospasm c. Rocuronium d. Mivacurium ANS: B Laryngospasm is treated with mechanical ventilation or, in severe cases, administration of succinylcholine to paralyze the muscles.

DIF:

2

REF: p. 290

15. Preoperative is required to minimize aspiration (inhalation) of gastric contents during general anesthesia. a. apnea b. bronchial c. fasting d. crisis ANS: C Preoperative fasting is required to minimize aspiration (inhalation) of gastric contents during general anesthesia.

DIF:

2

REF: p. 274

16. In a state of well-being, the body responds readily to a. stimuli b. analgesics c. narcotics

SOURCE: Browsegrades.net

to maintain life.

d. barbiturates ANS: A In a state of well-being, the body responds readily to stimuli to maintain life.

DIF:

2

REF: p. 274

17. In anesthesia, is the patient’s inability to recall events that occur after the administration of specific drugs. a. pain relief b. hallucinations c. anterograde amnesia d. relief from nausea ANS: C In anesthesia, anterograde amnesia is the patient’s inability to recall events that occur after the administration of specific drugs. After the drug is metabolized and cleared from the body, normal recall returns.

DIF:

2

REF: p. 268

18. Patients undergoing conscious sedation are monitored a. continuously b. generally c. carefully d. minimally

throughout the procedure.

ANS: A Patients undergoing conscious sedation are monitored continuously throughout the procedure.

DIF: 19. a. b. c. d.

2

REF: p. 285

is a rare physiological response to all volatile anesthetic agents and succinylcholine.

Malignant hyperthermia (MH) Anaphylactic shock Coma Hemolytic reaction

ANS: A MH is a rare physiological response to all volatile anesthetic agents and succinylcholine.

DIF:

2

REF: p. 291

20. The capture and safe removal of anesthetic gas that escapes from the anesthesia machine is accomplished with a system. a. circular b. gas scavenging c. intubation d. regional block

SOURCE: Browsegrades.net

ANS: B Gas scavenging is the capture and safe removal of extraneous anesthetic gases from the anesthesia machine.

DIF:

2

REF: p. 268

21. The circulation of blood to specific tissue, organ, system, or the whole body is called . a. perfusion b. transfer c. intubation d. sedation ANS: A Circulation of blood to specific tissue, organ, system, or the whole body is called perfusion.

Perfusion is necessary to maintain life in the cells.

DIF:

2

REF: p. 269

22. Topical anesthesia is used on surgery. a. red cells b. mucous membranes c. subcutaneous tissue d. superficial nerves

and on superficial eye tissues during ophthalmic

ANS: B Topical anesthesia is used on mucous membranes and on superficial eye tissues during ophthalmic surgery.

DIF:

2

REF: p. 286

23. A nerve block provides anesthesia to a specific area of the body supplied by a major nerve or nerve plexus (group). a. peripheral b. constant c. intermittent d. intravenous ANS: A A peripheral nerve block provides anesthesia to a specific area of the body supplied by a major nerve or nerve plexus (group).

DIF: 24.

2

REF: p. 287 is the immediate harvesting of blood on the surgical field and reinfusion

to the patient. a. Blood transfusion b. Intraoperative cell salvage c. Extubation

SOURCE: Browsegrades.net

d. Gas scavenging ANS: B Intraoperative cell salvage (autotransfusion) is the immediate harvesting of blood on the surgical field and reinfusion into the patient.

DIF: 25. a. b. c. d.

2

REF: p. 291

is a state of balance in physiological functions.

Homeostasis Hemostasis Emergence Perfusion

ANS: A Homeostasis is a state of balance in physiological functions.

DIF:

2

REF: p. 269

26. A pulse is a monitoring device that measures the patient’s hemoglobin oxygen saturation by means of spectrometry. a. hemostasis b. balancer c. oximeter d. anesthesia ANS: C CeOaM A pulse oximeter is a moniN toU rinRgSdI evNicGeTthBa. tm sures the patient’s hemoglobin oxygen saturation by means of spectrometry.

DIF:

2

REF: p. 275

27. Deep unconsciousness, such as that achieved during general anesthesia, results in the absence of protective mechanisms such as swallowing, coughing, blinking, and a. recall b. cessation c. shivering d. capacity

.

ANS: C Deep unconsciousness, such as that achieved during general anesthesia, results in the absence of protective mechanisms, such as swallowing, coughing, blinking, and shivering.

DIF:

2

REF: p. 270

28. Central nervous system depression refers to capacity. a. changed b. instant c. peristalsis d. diminished

mental, sensory, and physical

SOURCE: Browsegrades.net

ANS: D Central nervous system depression refers to diminished mental, sensory, and physical capacity.

DIF:

2

REF: p. 270

29. The assistant assists the anesthesia care provider in tasks that are delegated according to the AA’s practice skills and knowledge. a. surgical b. ACP c. nursing d. certified anesthesia ANS: D The certified anesthesia assistant (CAA) assists the anesthesia care provider in tasks that are delegated according to the AA’s practice skills and knowledge.

DIF:

2

REF: p. 270

30. Hospitals have individual a. identity b. check-in c. consent forms d. religious preferences

protocols; however, specific details are always verified.

ANS: B Hospitals and other surgicaN l fUaR cilS itI ieN s hGaT veBi. ndCivOidMual check-in protocols. However, specific details are always verified.

DIF:

2

REF: p. 273

31. Diagnostic testing to determine the patient’s decades. a. risk b. sedative c. prophylactic d. inhalation

level has been routine for many

ANS: A Diagnostic testing to determine the patient’s risk level has been routine for many decades.

DIF:

2

REF: p. 272

32. Preoperative medications are documented in the patient’s medical and a. anxiety b. preoperative c. gastric d. general ANS: B

SOURCE: Browsegrades.net

records.

Preoperative medications are documented in the patient’s medical and preoperative records.

DIF:

2

REF: p. 273

33. Any medication ordered but not yet given may be administered in the holding area as directed by the surgeon or . a. CPA b. BIT c. ACP d. EAP ANS: C Any medication ordered but not yet given may be administered in the holding area as directed by the surgeon or ACP. DIF:

2

34. Historically, on the hospital ward. a. backspace b. preoperative c. preventive d. patient

REF: p. 273 drugs were given routinely, while the patient was awaiting surgery

ANS: B Historically, preoperative drugs were given routinely, while the patient was awaiting surgery on the hospital warN d. R I G B.C M

U S N T

DIF:

2

O

REF: p. 273

35. Normal body temperature is a. 94° to 99.5° C b. 95° to 97° C c. 97° to 99.5° F d. 36° to 37.5° F

.

ANS: C The normal body temperature is 97° to 99.5° F (36° to 37.5° C).

DIF:

2

REF: p. 277

36. Toxic reactions to local anesthetics arise most often during anesthesia. a. specific b. injection c. regional d. postoperative

block and epidural

ANS: C Toxic reactions to local anesthetics arise most often during regional block and epidural anesthesia.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 289

37. A coma is a state of deep a. anesthesia b. Esmarch concentration c. sleep d. unconsciousness

, in which most brain activity ceases.

ANS: D Coma is the deepest state of unconsciousness, in which most brain activity ceases.

DIF:

2

REF: p. 270

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Analgesia b. Anesthesia c. Anesthetic 1.

2.

3.

4.

A drug that produces lack of sensation The absence of pain caused by specific drugs Without sensation Dosage is calculated by patient’s weight

1. ANS: 2. ANS: 3. ANS: 4. ANS:

C A B C

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 268 p. 268 p. 269 p. 286

SOURCE: Browsegrades.net

Chapter 14: Postanesthesia Recovery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The PACU is staffed by trained in postoperative recovery and emergency treatment. a. certified surgical technologists b. certified registered nurse anesthetists c. critical care nurses d. anesthesiologists ANS: C The PACU is staffed by critical care nurses who are trained in postoperative recovery and emergency medicine.

DIF:

2

REF: p. 295

2. The PACU is close to the surgical suites for a. lounge b. changing c. central d. rapid

transfer of patients after surgery.

ANS: D The PACU is close to the sN urgiR cal I suitG es for B.raCpidMtransfer of patients after surgery.

U S N T

DIF:

2

O

REF: p. 295

3. Drugs given during the preoperative and intraoperative phase have a direct pharmacological effect on those administered . a. by anesthesia b. postoperatively c. for pain d. by injection ANS: B Drugs given during the preoperative and intraoperative phase have a direct pharmacological effect on those administered postoperatively.

DIF: 4. a. b. c. d.

2

REF: p. 296

is necessary to determine the need for further action, such as transfusion.

Type of anesthesia administered Surgical procedure performed Estimated blood loss Patient age

ANS: C

SOURCE: Browsegrades.net

The estimated blood loss is necessary to determine the need for further action, such as transfusion.

DIF:

2

REF: p. 296

5. Malignant (MH) is a rare condition that results in an extremely high core body temperature, cardiac dysrhythmia, tachypnea (increased respiratory rate), hypoxia, and hypercarbia. a. hypoventilation b. hypothermia c. hyperthermia d. hypoxia ANS: C Malignant hyperthermia (MH) is a rare condition that results in an extremely high core body temperature, cardiac dysrhythmia, tachypnea (increased respiratory rate), hypoxia, and hypercarbia.

DIF:

2

REF: p. 300

6. A standardized method of measuring the patient’s response to external stimuli is known as . a. patient assessment b. focus assessment c. Glasgow Coma Scale (GCS) d. head to toe assessment ANS: C GCS is a standardized method of measuring a patient’s response to external stimuli.

DIF:

2

REF: p. 295

7. During surgery preparation, the patient’s a. code status b. nutritional status c. family support system d. physiological status

is continually monitored.

ANS: D The circulating nurse or the ACP communicates all information needed to update the PACU nurse on the patient’s physiological status before and during surgery.

DIF: 8.

2

REF: p. 296

is a term used to describe a clinical scenario in which patients are prescribed many different medications. a. Polypharmacy b. ADL c. Discharge orders d. Care plan

SOURCE: Browsegrades.net

ANS: A Polypharmacy is a clinical scenario in which patients are prescribed many different medications, sometimes by different primary health care providers who have no knowledge of other drugs the patient is taking.

DIF:

2

9. Patient possible. a. transport b. delivery c. provider d. schedule

REF: p. 302 to home or another care facility is arranged before surgery whenever

ANS: A Patient transport to home or another care facility is arranged before surgery whenever possible.

DIF: 10. a. b. c. d.

2

REF: p. 302

problems are the most frequent life-threatening postoperative complication.

Wound hemorrhage Pain management Respiratory Anesthetic agent

ANS: C Respiratory problems are the most frequent life-threatening postoperative complication.

DIF:

2

REF: p. 299

11. Although is expected in the postsurgical phase, not all patients respond to pain in the same way. a. pain b. neurological function c. mental status d. level of consciousness ANS: A Although pain is expected in the postsurgical phase, not all patients respond to pain in the same way.

DIF:

2

REF: p. 299

12. Pain at the operative site is another cause of a. consciousness b. hypoxia c. imbalances d. hypoventilation

_, resulting in low oxygen saturation.

ANS: D

SOURCE: Browsegrades.net

Pain at the operative site is another cause of hypoventilation, resulting in low oxygen saturation.

DIF:

2

REF: p. 300

13. Discharge planning and implementation follow established roles and tasks according to hospital . a. policy b. assessment c. focus d. ASA ANS: A Discharge planning and implementation follow established roles and tasks according to hospital policy.

DIF:

2

REF: p. 301

14. Patient teaching is the responsibility of a. prepared b. ready c. trained d. experienced

nursing personnel.

ANS: C Patient teaching is the responsibility of trained nursing personnel.

DIF:

2

N R I G B.COM

REF: Up. 3S02N T

15. In the event of impending or a rapidly deteriorating patient, surgery may be terminated and the patient taken to the PACU. a. order b. stop c. death d. discharge ANS: C In the event of impending death or a rapidly deteriorating patient, surgery may be terminated and the patient taken to the PACU. DIF:

2

REF: p. 303

16. A potentially fatal syndrome of hypermetabolism resulting in extremely high body temperature, cardiac dysrhythmia, and respiratory distress is known as . a. hypoventilation b. hypoxia c. hypothermia d. malignant hyperthermia (MH) ANS: D

SOURCE: Browsegrades.net

MH is a potentially fatal syndrome of hypermetabolism that results in an extremely high body temperature, cardiac dysrhythmia, and respiratory distress.

DIF:

2

REF: p. 300

17. Wound and care are of primary importance during the postoperative period. a. department b. suspension c. inputs d. assessment ANS: D Wound assessment and care are of primary importance during the postoperative period.

DIF:

2

REF: p. 296

18. The is assessed for distention (which may indicate the presence of fluid, including blood) or air. a. abdomen b. operatives c. volume d. treatment ANS: A The abdomen is assessed for distention (which may indicate the presence of fluid, including blood) or air.

DIF:

2

19. The a. ICU b. PACU c. USP d. CBC

N R I G B.COM

REF: Up. 2S97N T

staff provides continual emotional support to the patient.

ANS: B The PACU staff provides continual emotional support to the patient.

DIF:

1

REF: p. 299

20. Both and bronchospasm can be caused by particular anesthetic agents. a. laryngospasm b. perfusion c. auscultation d. arterial blood gases ANS: A Both laryngospasm and bronchospasm can be caused by particular anesthetic agents.

DIF:

1

REF: p. 300

SOURCE: Browsegrades.net

21. Perfusion or oxygen saturation of the blood is measured by a. arterial blood gases b. pulse oximeter c. Glasgow Coma Scale d. ADLs

.

ANS: B Perfusion (flow of blood to tissue) is measured by pulse oximeter.

DIF:

1

REF: p. 297

22. The assessment is used by the PACU nurse to concentrate on a specific organ system or region of the body. a. head to toe b. focused c. accepted d. fluid ANS: B The focused assessment is used by the PACU nurse to focus on a specific organ system or region of the body.

DIF:

1

REF: p. 297

23. Fluid shifts from the vascular space to the intracellular space can occur after surgery, and the patient must be carefully. a. evaluated b. accelerated c. focused d. dehydrated ANS: A Fluid shifts from the vascular space to the intracellular space can occur after surgery, and the patient must be evaluated carefully.

DIF:

1

24. Assessment for a. dehydration b. hyperthermia c. perfusion d. auscultation

REF: p. 297 includes physical signs and symptoms.

ANS: A Assessment for dehydration includes physical signs and symptoms.

DIF:

1

REF: p. 297

25. Patients often need reassurance and orientation to their general anesthesia or heavy sedation. a. environment

SOURCE: Browsegrades.net

while emerging from

b. education c. perfusion d. hydration ANS: A Patients often need reassurance and orientation to their environment while emerging from general anesthesia or heavy sedation.

DIF:

1

REF: p. 299

26. Pulmonary is blockage of a pulmonary vessel by air, a blood clot, or other substance (e.g., fragments of atherosclerotic plaque). a. embolism b. clotting c. dehydration d. irritation ANS: A Pulmonary embolism is blockage of a pulmonary vessel by air, a blood clot, or other substance (e.g., fragments of atherosclerotic plaque).

DIF:

1

REF: p. 300

27. Many anesthetic agents are cardiac irritants that can sensitize the disturbances in rhythm, rate, and cardiac output. a. transport b. cardiac c. heart d. patient’s

muscle to

ANS: C Many anesthetic agents are cardiac irritants that can sensitize the heart muscle to disturbances in rhythm, rate, and cardiac output.

DIF:

2

REF: p. 300

28. Patients are informed and educated about their own care so that they can fully participate in their . a. recovery b. pain assessment c. social assessment d. wound assessment ANS: A Patients are informed and educated about their own care so that they can fully participate in their recovery.

DIF:

2

29. The a. NBA

REF: p. 301 provides specific orders for continuation of care and a smooth recovery.

SOURCE: Browsegrades.net

b. ACP c. PTA d. CPR ANS: B The ACP provides specific orders for continuation of care and a smooth recovery.

DIF:

2

REF: p. 296

30. Partial or complete closure of the bronchial tubes is a. bronchospasm b. percussion c. perfusion d. hypoxia

.

ANS: A Bronchospasm is the partial or complete closure of the bronchial tubes.

DIF:

2

REF: p. 300

31. The estimated blood loss is needed to determine the need for further action, such as . a. rhythm b. palpation c. transfusion d. auscultation ANS: C The estimated blood loss is needed to determine the need for further action, such as transfusion.

DIF:

2

REF: p. 296

32. The heart is monitored for rate and rhythm using produces a digital waveform. a. EKG b. BBC c. KRG d. ECG

leads and a cardiac monitor, which

ANS: D The heart is monitored for rate and rhythm using ECG leads and a cardiac monitor, which produces a digital waveform.

DIF:

2

33. The central jugular veins. a. nervous b. venous c. digestion

REF: p. 297 pressure may be measured with an inline catheter or by observing the

SOURCE: Browsegrades.net

d. tension ANS: B The central venous pressure may be measured with an inline catheter or by observing the jugular veins.

DIF:

2

34.

REF: p. 297 can occur during surgery or in the postoperative period.

a. b. c. d.

Hemorrhage Change Standards Normotensive

ANS: A Hemorrhage can occur during surgery or in the postoperative period.

DIF:

2

REF: p. 300

35. Patients and family receive referral numbers for a. transportation b. PACU c. assistance d. emergency

care or further information.

ANS: D Patients and family receive referral numbers for emergency care or further information.

DIF:

2

REF: p. 302

36. In the event the patient has no assistance available, community resources, including services and professional home nursing services, must be brought in. a. technology b. surgeon c. social d. personnel ANS: C In the event the patient has no assistance available, community resources, including social services and professional home nursing services, must be brought in.

DIF:

2

REF: p. 302

37. Physiological objectives that are necessary to ensure patient safety outside the critical care unit are called . a. discharge scores b. discharge criteria c. discharge planning d. discharge signs ANS: B

SOURCE: Browsegrades.net

Discharge criteria are primarily physiological objectives, which are necessary to ensure patient safety outside the critical care unit.

DIF:

2

REF: p. 301

38. Aspiration or inhalation of secretions or stomach contents is associated with a weak gag related to use of narcotics, sedatives, and anesthetic agents. a. level of consciousness b. cardiopulmonary status c. reflex d. mental status ANS: C Aspiration or inhalation of secretions or stomach contents is associated with a weak gag reflex related to use of narcotics, sedatives, and anesthetic agents.

DIF: 39.

2

REF: p. 300

(hand-off) is a verbal and written report from one nurse to another to provide updated patient information. a. Hypoxia b. Handover c. Hyperoxygenation d. Hypovolemia ANS: B Handover (hand-off) is a veNrbaR l anI d wG ritteB n. reC porM t from one nurse to another to provide O updated patient information. U S N T DIF:

2

REF: p. 296

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Anesthesia provider b. PACU nurse c. Surgical patient 1.

2.

3.

4.

5.

6.

7.

Communicates specific orders for continuation of care and a smooth recovery Performs duties in the postanesthesia care area May sign out of the health care facility AMA Accountable for ensuring that the family members are alerted and kept up to date Informed and educated to fully participate in the recovery phase Arrangements for discharge ADLs often determine their quality of life

1. ANS: A 2. ANS: B

DIF: DIF:

3 3

REF: p. 296 REF: p. 295

SOURCE: Browsegrades.net

3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS:

C B C B C

DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3

REF: REF: REF: REF: REF:

p. 303 p. 297 p. 301 p. 302 p. 302

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Glasgow Coma Scale b. Aldrete scale 8.

9.

10.

11.

12.

13.

14.

Based on psychosocial and physiological criteria Often used to determine whether a patient is ready for discharge from the PACU area A standardized method of measuring the patient’s response to external stimuli Used to assess motor response to verbal commands Vital signs are stable and reflect patient’s baseline normal Incision site is dry and drainage absent or within expected limits Confirms home environment is suitable for recovering patient

8. ANS: 9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS:

B B A A B B B

DIF: 3 REF: p. 301 DIF: 3 REF: p. 301 DIF: 3 REF: p. 297 DIF: 3 REF: p. 297 DIF: 3 REF: p. 301 DIF: 3 REF: p. 302 DIF:NU3RSINGTB.RC EO F:M p. 302

SOURCE: Browsegrades.net

Chapter 15: Death and Dying Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Physical care of the body to prepare it for viewing by the family and for mortuary procedures is called . a. morgue care b. postmortem care c. premortem care d. mortuary ANS: B Physical care of the body to prepare it for viewing by the family and for mortuary procedures is called postmortem care.

DIF:

2

REF: p. 309

2. Support and care across different cultures is called a. cultural competence b. culture knowledge c. culture acceptance d. culture awareness

.

ANS: A Support and care across cultures culturalMcompetence. It is learned through NURSisIcalled GTB.C N experience and active learning. It begins with acOceptance and respect.

DIF:

2

REF: p. 308

3. Medical and supportive care provided to the dying patient is called a. premortem b. comfort c. dignity d. palliative

care.

ANS: D Palliative care is the medical and supportive care provided to the dying patient. Numerous types of surgical intervention may be included as a component of palliative care, such as debulking of a tumor or debridement of a pressure wound.

DIF:

2

REF: p. 308

4. When death occurs in surgery, the surgeon and the anesthesia care provider must verify that brain death has occurred; this is called of death. a. proclamation b. certificate c. announcement d. determination

SOURCE: Browsegrades.net

ANS: D When death occurs in surgery, the surgeon and the anesthesia care provider must verify that brain death has occurred; this is called determination of death. Death is determined by specific medical criteria, which have legal implications.

DIF:

2

REF: p. 308

5. Rigor mortis, the natural stiffening of the body, begins approximately and peaks at 8 to 10 hours. a. 15 minutes b. 30 minutes c. 1 hour d. 1.5 hours

after death

ANS: A Rigor mortis, the natural stiffening of the body, begins approximately 15 minutes after death and peaks at 8 to 10 hours. The exact time depends on the tissues and environmental temperature. At 18 hours, the process regresses, and the body usually is relaxed after 24 hours. Rigor mortis begins at the head (eyelids) and progresses to the feet. When relaxation begins, it follows the reverse order of progression.

DIF:

2

REF: p. 309

6. After death, the collection of fluid that turns the ears and cheeks red or purple is called mortis. a. rigor b. post c. livor d. pooled ANS: C Dependent areas of the body (those under pressure from body weight or gravity) begin to collect fluid, and the areas around the ears and cheeks may turn purple or red (a condition called livor mortis). The pooling of blood in these regions cannot be reversed in the embalming process.

DIF:

2

REF: p. 309

7. A structured response may be required to help health care workers cope with death. This may involve planned periods, or spontaneous expressions of support and acknowledgment by individual team members. a. vacation b. reassignment c. debriefing d. distracting ANS: C A structured response may be required to help health care workers cope with death. This may involve planned “debriefing” periods, or spontaneous expressions of support and acknowledgment by individual team members.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 311

8. Because death in the operating room any sentinel event. a. is a sentinel event b. is unusual c. is uncommon d. does not happen

, the circulator must initiate all forms as for

ANS: A Because death in the operating room is a sentinel event, the circulator must initiate all forms as for any sentinel event. If death was pronounced in the operating room, members of the surgical team are named in the sentinel event documentation.

DIF:

2

REF: p. 309

9. Communication with the dying patient requires a. avoidance of the subject b. keen listening and observation skills c. assurance that all will be okay d. refusal to listen

.

ANS: B Communication with the dying patient requires keen listening and observation skills. It is important to recognize and acknowledge the fact of death and what this means to the patient in that moment and time.

DIF:

2

REF: p. 306

10. The circumstances of the patient’s death determine whether the coroner must investigate the death; this process includes mandatory autopsy, and such a case is called a(n) . a. supervisor's case b. administrator’s case c. medical staff case d. coroner’s case ANS: D The circumstances of the patient’s death determine whether the coroner must investigate the death; this process includes mandatory autopsy, and such a case is called a coroner’s case.

DIF:

2

REF: p. 309

11. Reactions and coping skills available to health care professionals are influenced by the following factors, EXCEPT . a. lack of support b. the health care professional’s beliefs and values c. previous experience with death d. emotional well-being ANS: A

SOURCE: Browsegrades.net

Emotional and psychological events triggered by the sudden death of a patient vary in health care workers. The reactions and coping skills available to these professionals often are influenced by the following factors: • Previous experience with death • Support available in the environment • The health care professional’s beliefs and values • Knowledge about the process of death • The health care professional’s emotional well-being DIF:

2

REF: p. 310-311

12. If no decision has been made by the patient, the attending patient and family to consider organ donation. a. physician b. family c. chaplain d. nurses

must, by law, ask the

ANS: A Many cultures and faiths forbid organ removal after death, and these cases usually are straightforward for the family and patient. However, individuals often leave the question unresolved at the time of death. If no decision has been made by the patient, the attending physician must, by law, ask the patient and family to consider organ donation. In cases of sudden death without clear directives, conflicting views may be held by family members about organ donation.

DIF:

2

. 3S1I 0NGTB.COM REFN : UpR

13. The theory of death is considered by some too constricting and does not allow for individualism in the experience of death. a. stage b. end of life c. spiritual d. psychological ANS: A Critics of Kübler-Ross’s model believe that the stage theory is too constricting and does not allow for individualism in the experience of death. However, the stage model provided a framework for psychologists and social workers to look at the process of dying in a way that had not been previously studied.

DIF:

2

REF: p. 306

14. Effective and compassionate communication with the family and the patient is enhanced by understanding some of the more common problems families face. These not only include the effects of grief but can also be related to the patient’s medical care, or to the practical aspects of finances and estate issues. a. physical b. physiological c. psychological

SOURCE: Browsegrades.net

d. pathological ANS: C The families of dying patients face many challenges and difficulties in the end of life period.

Effective and compassionate communication with the family and the patient is enhanced by understanding some of the more common problems families face. These not only include the psychological effects of grief but can also be related to the patient’s medical care, or to the practical aspects of finances and estate issues.

DIF:

2

REF: p. 311

15. Assisted suicide is perceived by many as an intent to a. help b. cure c. harm d. heal

.

ANS: C Assisted suicide is perceived by many as intent to harm and on that basis is rejected.

Assisted suicide is intentional harm to a person, at their request, to promote or cause death.

DIF:

2

REF: p. 307

16. Decisions about end-of-life care fall to the communicate his or her wishes. a. friends b. family c. hospital administrator d. clergy

when the patient is not able to

ANS: B Ethical issues arise when the patient is not competent to communicate. Decisions about end-of-life care fall to the family when the patient is not able to communicate his or her wishes.

DIF:

2

REF: p. 307

17. Many cultures and faiths forbid organ removal after death, and these cases are usually . a. difficult to persuade the patient and family b. straightforward for the family and patient c. confusing for the family and patient d. decided by the physician ANS: B Many cultures and faiths forbid organ removal after death, and these cases usually are straightforward for the family and patient. However, individuals often leave the question unresolved at the time of death.

DIF:

1

REF: p. 310

SOURCE: Browsegrades.net

18. Although grief and other deep emotions are present in all families at the time of death, these feelings are often mitigated by ritual and ceremony that . a. comfort as well as heal the living b. allow the families to forget c. let families pretend nothing happened d. allow families to think about their grief ANS: A Although grief and other deep emotions are present in all families at the time of death, these feelings often are mitigated by ritual and ceremony, which comfort as well as heal the living. In many cultures, they also are believed to comfort the dead.

DIF:

1

REF: p. 308

19. To determine brain death, specific medical assessment may be carried out on the patient to determine absence of breathing, the response to painful stimuli, and the presence of . a. cranial reflexes b. acuity response c. respiratory reflexes d. cardiac response ANS: A Death is determined by specific medical criteria, which have legal implications. To determine brain death, specific medical assessment may be carried out on the patient to determine absence of breathing, the response to painful stimuli, and the presence of cranial reflexes.

DIF:

1

REF: p. 308-309

20. During the aftercare procedure, the body is handled times. a. slowly; care b. gently; respect c. quickly; care d. leisurely; worry

and with

at all

ANS: B During the aftercare procedure, the body is handled gently and with respect at all times.

DIF:

1

REF: p. 309

21. Once the decision has been made for organ recovery, exacting clinical protocols are followed to ensure . a. there are no mistakes b. the vitality of the organs c. permission is not withdrawn d. respect is given ANS: B

SOURCE: Browsegrades.net

Once the decision has been made for organ recovery, exacting clinical protocols are followed to ensure the vitality of the organs.

DIF:

1

REF: p. 310

22. Health care workers often face personal conflict about the decisions made by their patients or the families of patients. They may not agree with the decisions, but they are obliged to . a. propose a different outcome b. honor the decisions c. change the mind of the patient d. share an opinion ANS: B Health care workers often face personal conflict about the decisions made by their patients or the families of patients. They may not agree with the decisions, but they are obliged to honor them. In extreme cases of ethical conflict, the health care professional may ask to be excused from participation in the care of the patient.

DIF:

1

REF: p. 308

23. A is one in which tissue perfusion can be maintained during and immediately after death to preserve the life of the tissue. a. heart-beating cadaver b. non-heart-beating cadaver c. breathing cadaver d. non-breathing cadaver ANS: A A heart-beating cadaver is one in which tissue perfusion can be maintained during and immediately after death to preserve the life of the tissue. Cardiopulmonary support provides intact circulation to organs suitable for recovery.

DIF:

1

REF: p. 310

24. The order to not resuscitate is made official by signing a DNR (do not resuscitate) order, which is . a. sent to the hospital attorney b. charted in the patient’s medical record c. kept secret d. shared only with the hospital administrator ANS: B Request not to resuscitate is made official when the patient signs a DNR order, which is charted in the patient’s medical record. Exacting forms that define precisely the procedures that can and cannot be performed during resuscitation have been designed to alleviate ambiguity.

DIF:

1

REF: p. 308

SOURCE: Browsegrades.net

25. Tissues that are harvested from non-heart-beating cadavers include a. cornea, blood vessels, heart valves, bone, and skin b. lungs, kidneys, liver, and intestines c. stomach, bladder, pancreas, gall bladder d. kidneys, gall bladder, heart valves, bone

.

ANS: A Tissues from a non-heart-beating cadaver are restricted to those that do not need perfusion to sustain viability for later transplantation. These include the cornea, blood vessels, heart valves, bone, and skin.

DIF:

1

REF: p. 310

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Stages of grief and dying b. Natural changes in the body after death c. Advanced directive 1.

2.

3.

4.

DNR or DNAR (do not attempt resuscitation) Rigor mortis All sphincter muscles immediately lose tone Patients feel great anger and remorse that they did not heed warnings to change lifestyle habits they knew were harmful.

5. An inner attempt to bargainNw UiR thSGIoN dG orTaB no.thCeO r sMpiritual entity 6. The patient may refuse treatment in order to fulfill the right to die.

7. Areas of the body begin to collect fluid and the areas around the ears and cheeks may turn purple or red.

8. Living will 9. Patients express anger; feelings of anger may be projected at family, self, health workers, or God. 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS:

C B B A A C B C A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 308 p. 309 p. 309 p. 306 p. 306 p. 307 p. 309 p. 308 p. 306

Choose from the terms listed and match them with their most correct description. a. Denial b. Bargaining c. Acceptance

SOURCE: Browsegrades.net

10. “If I pray daily, maybe God will allow me to live.”

11. Is a defense mechanism 12. The idea that death is no longer a source of psychological conflict 10. ANS: B 11. ANS: A 12. ANS: C

DIF: DIF: DIF:

3 3 3

REF: p. 306 REF: p. 306 REF: p. 306

SOURCE: Browsegrades.net

Chapter 16: Physics and Information Technology Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The is the primary unit that makes up all physical matter. It behaves in very distinct and predictable ways. a. electron b. element c. atom d. isotope ANS: C The atom is the primary unit that makes up all physical matter. It behaves in very distinct and predictable ways.

DIF:

2

REF: p. 314

2. Physics is the complex study of matter, time, energy, a. energy b. power c. force d. frequency

, and space.

ANS: C The origins of mechanics are inGtheB.C laws ofMphysics. Physics is the complex study of NUfound RSIN T matter, time, energy, force, and space. Physics dOescribes the natural behavior of these concepts using complex mathematics.

DIF:

2

3. In physics, a. amplitude b. mechanics c. hertz d. energy

REF: p. 314 is the study of objects and motion.

ANS: B Mechanics is the study of motion and objects. Mechanics is involved in both the handheld retractor and the computerized system that tells the surgeon how to remodel the patient’s facial bones. Mechanics also is involved in heat, light, sound, electricity, and all the other forms of energy used in medical technology.

DIF:

2

REF: p. 314

4. The negative or lowest point on a wave is a a. reflection b. wavelength c. trough

SOURCE: Browsegrades.net

.

d. hertz ANS: C The crest is the highest point of disturbance, and the trough is the negative or lowest point of disturbance. The resting point is the area of no disturbance or movement and is represented by the straight line.

DIF:

2

REF: p. 316

5. The force or power that pushes or drives electrons through the conductive material is called . a. current b. resistance c. conductivity d. voltage ANS: D The force or power that pushes or drives electrons through the conductive material is called voltage. This is the potential energy expressed as units of charge.

DIF:

2

REF: p. 318

6. A lens is thinner at the middle than at the edges and causes the light to diverge or spread. a. concave b. refractive c. insulated d. convex ANS: A A simple convex lens is thinner at the edges than at the middle. A concave lens is thinner at the middle than around the edges and causes the light to diverge or spread.

DIF:

2

REF: p. 319

7. When the rays are focused in a single area, the area is called the a. middle b. concave center c. focal point d. refractive index

.

ANS: C When the rays are focused in a single area, the area is called the focal point. The shape of a lens determines how the light rays bend as they pass through it.

DIF:

2

REF: p. 319

8. These programs are designed to help the user learn subjects such as mathematics, languages, and physical sciences. a. Word processing b. Database

SOURCE: Browsegrades.net

c. Graphic design d. Interactive educational programs ANS: D Interactive educational programs are designed to help the user learn subjects such as mathematics, languages, and physical sciences. Educational programs are available for nearly any subject.

DIF: 9.

2

REF: p. 323

is a medical device that uses the effect and ultrasonic waves to measure and record blood flow as well as tissue density and shape. a. Doppler ultrasound, Doppler b. Thermal conductivity, Doppler c. Conductivity, conduction d. Radiation, Doppler ANS: A Doppler ultrasound is a medical device that uses the Doppler effect and ultrasonic waves to measure and record blood flow as well as tissue density and shape.

DIF:

2

REF: p. 321

10. In computer technology, the a. disc b. hard copy c. file d. database

is a paper form of data.

ANS: B Hard copy data is computer output which has been reproduced in the form of a CD, digital video, or paper printout.

DIF:

2

REF: p. 322

11. The or icon is activated by setting the cursor on the pressing one of the mouse buttons (right or left). a. cursor, icon b. hyperlink, cursor c. command, icon d. task bar, icon

or text and

ANS: C A command or icon is activated by setting the cursor on the icon or text and pressing one of the mouse buttons (right or left).

DIF:

2

REF: p. 323

12. In computer technology, the a. CPU b. search engine

is the computer’s memory capacity.

SOURCE: Browsegrades.net

c. RAM d. toolbar ANS: C The computer’s memory capacity, also called RAM or random access memory, connects with the main electrical circuits to perform all the tasks needed to operate the computer.

Data placed in RAM must be saved on other hardware called the drive.

DIF:

2

REF: p. 322

13. The state of a substance occurs when the energy applied to it is greater than the energy bonds that hold the molecules together. a. vaporizing b. melting c. molecular d. gas ANS: D These forms—liquid, solid, gas, and plasma—are referred to as the states of matter. Most substances can exist in a variety of states. For example, when water is heated to 212° F (100° C), it becomes steam, its gaseous state. The state of the water has changed from liquid to gas, but it retains its molecular structure.

DIF:

2

14.

REF: p. 316 is the number of waves that pass a point in 1 second.

a. b. c. d.

Frequency Wavelength Amplitude Wave energy

ANS: A Frequency is the number of waves that pass a point in 1 second. The unit of measurement for electromagnetic frequency is the hertz (Hz).

DIF:

2

REF: p. 316

15. The is the point of greatest disturbance or the height of an individual wave. This is measured in meters from the top of the crest to the point of rest. a. wavelength b. amplitude c. boiling point d. frequency ANS: B Amplitude is the point of greatest disturbance, or the height of an individual wave. This is measured in meters from the top of the crest to the point of rest.

DIF:

1

REF: p. 316

SOURCE: Browsegrades.net

16. When energy is applied to a spring to compress it, the spring travels a distance, returns to its original position (neutral), and then moves in the opposite direction. This is called . a. oscillation b. force c. conduction d. amplitude ANS: A When energy is applied to a spring to compress it, the spring travels a distance, returns to its original position (neutral), and then moves in the opposite direction. This movement is called an oscillation. If the force is applied to the spring only once, the spring continues to oscillate at lower and lower levels and then comes to rest.

DIF:

1

17. A formation. a. liquid b. solid c. insulator d. photon

REF: p. 321 is a substance in which the molecules are tightly bound in rigid

ANS: B A solid is a substance in which the molecules are tightly bound in rigid formation. A liquid is formed when heat (energy) is applied to a solid. Common experience teaches us that some substances melt more readiN ly thRan I otheGrs. B.C M

U S N T

DIF:

1

O

REF: p. 316

18. Surgical technologists must ensure safe use of electrical equipment, assemble and troubleshoot complex devices, and their use on the surgical field. a. assist in b. forbid c. insist upon d. encourage ANS: A Modern surgical technologists must ensure the safe use of electrical equipment, assemble and troubleshoot complex devices, and assist in their use on the surgical field.

DIF:

1

REF: p. 314

19.

is the complex study of matter, time, energy, force, and space. a. b. c. d.

Biomedical sciences Physics Doppler ultrasound Thermoregulation

ANS: B

SOURCE: Browsegrades.net

The origins of mechanics are found in the laws of physics. Physics is the complex study of matter, time, energy, force, and space. Physics describes the natural behavior of these concepts using complex mathematics. For example, without the mathematical formulas, we must simply accept that when an object is dropped from a height, it accelerates through space as it falls.

DIF:

1

REF: p. 314

20. A(n) is much smaller than a proton or neutron. Its weight is almost negligible compared with the nuclear particles. a. electron b. molecule c. particle d. atomic nucleus ANS: A An electron is much smaller than a proton or neutron. Its weight is almost negligible compared with the nuclear particles.

DIF:

2

REF: p. 315

MATCHING Match the term with the definition. Some answers may be used twice. a. Alternating current (AC) b. Amplitude c. Harmonics d. Conductivity e. Reflection f. Resistance g. Internal drives h. Voltage 1. The electrical force in a circuit, measured as the amount of force that passes a given point over a stated period.

2. Data storage that is an integral part of the computer 3. A type of electrical current in which electricity changes direction to complete its circuit 4. The relative ability of a substance to transmit free electrons or electricity 5. In electricity, the measurement of a substance’s ability to inhibit the flow of electricity 6. In electromagnetic wave energy, the height of a wave 7. The behavior of a wave when it reaches a nonabsorbent material; the wave reverses and is directed back toward the source.

8. The quality of sound related to the frequency of the sound waves 1. ANS: 2. ANS: 3. ANS: 4. ANS:

H G A D

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 314 p. 313 p. 313 p. 313

SOURCE: Browsegrades.net

5. ANS: 6. ANS: 7. ANS: 8. ANS:

F B E C

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 314 p. 313 p. 314 p. 313

SOURCE: Browsegrades.net

Chapter 17: Energy Sources in Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. During surgery, the perioperative team must suspect a problem if the surgeon repeatedly requests of the ESU. a. increases in power b. increases in sound level c. relocation d. decrease in power ANS: A During surgery, the perioperative team must suspect a problem if the surgeon repeatedly requests increases in power of the ESU. DIF:

2

REF: p. 335

2. During surgery, the active electrode pencil must be kept field. a. close to the surgical wound b. on the front edge of the Mayo stand c. on the patient’s legs d. in a nonconductive safety holster

on the surgical

ANS: D During surgery, the active electrode pencil must be kept in a nonconductive safety holster on the surgical field. The holster must be in plain sight of the team, and the ESU pencil must be replaced in it after each use.

DIF: 3.

2

REF: p. 336

materials are used to insulate the conductive material carrying electricity to prevent injury and maintain the flow of electricity within its circuit. a. Conductive b. Nonconductive c. Sterile d. Nonsterile ANS: B Nonconductive materials are used to insulate the conductive material carrying electricity to prevent injury and maintain the flow of electricity within its circuit. This is relevant to understanding how faults occur in electrosurgical devices and instruments that transmit electricity.

DIF:

2

REF: p. 330-331

4. During the use of electrosurgery or laser surgery, tissue is destroyed or incised, and this process creates toxic smoke called smoke , which is known to be highly toxic.

SOURCE: Browsegrades.net

a. b. c. d.

stream hazard toxicity plume

ANS: D During the use of electrosurgery or laser surgery, tissue is destroyed or incised, and this process creates toxic smoke called smoke plume. Smoke plume contains about 95% water and 5% other products. The other products include chemicals, blood cells, intact or fragmented bacteria, and viruses. The potential hazards of these substances are infectious disease transmission, toxicity from chemicals, and allergy.

DIF:

2

REF: p. 337

5. In coagulation mode, the a. heating is faster than b. voltage is higher than c. voltage is the same as d. voltage is lower than

in cutting mode.

ANS: D A continuous repetition of high-frequency waves at low voltage is characteristic of the cutting mode. Coagulation mode appears as intermittent waves at low-frequency high voltage.

DIF: 6.

2

REF: p. 335

N R I G B.C M

energy iU s creSateN d wT hen elecOtricity is transformed into mechanical energy to high-frequency vibration and friction. a. Ultrasonic b. Laser c. Cold thermal d. Electromagnetic ANS: A Ultrasonic energy is created when electricity is transformed into mechanical energy to high-frequency vibration and friction. The ultrasonic instrument simultaneously cuts and coagulates tissue by transmitting ultrasonic wave energy through specially designed forceps, scissors, or blades.

DIF:

2

REF: p. 338

7. The patient-return electrode must be placed close to the surgical site over . a. implants b. small muscle mass c. large bony protuberance d. large muscle mass ANS: D

SOURCE: Browsegrades.net

The patient-return electrode must be placed close to the surgical site over a large muscle mass. Muscle has low impedance and is the best conductor.

DIF: 8.

2

REF: p. 333

coupling is a specific burn hazard of monopolar endoscopic surgery when current passes inadvertently through instrument insulation and adjacent conductive material into tissue. a. Direct b. Capacitive c. Negative d. Loop ANS: B Capacitive coupling is a specific burn hazard of monopolar endoscopic surgery. It occurs when current passes inadvertently through instrument insulation and adjacent conductive material into tissue. Burns resulting from capacitive coupling are particularly dangerous in minimally invasive surgery because the injury most often occurs outside the viewing area of the endoscope.

DIF:

2

REF: p. 337

9. The result of constriction of electrical current by a nonconductive material or area of high density transforms electricity into energy. a. ultrasonic b. electromagnetic c. thermal d. laser ANS: C Impedance is the constriction of electrical current by a nonconductive material or area of high density. This results in the transformation of electricity into thermal energy.

DIF:

2

REF: p. 330

10. The flow of electricity is called a. voltage b. power c. ampere d. current

.

ANS: D Electricity is the flow of electrons through a conductive medium; this is called current.

DIF:

2

REF: p. 330

11. When the path of electricity is interrupted by a less-conductive medium, this is called . a. voltage b. current

SOURCE: Browsegrades.net

c. frequency d. impedance ANS: D The path of electricity from its origin to destination is the circuit. When electricity is introduced through a conductive circuit, it continues to flow along an unimpeded path.

When the path is interrupted by a less-conductive medium, the current will seek a path around the impedance.

DIF: 12. A a. b. c. d.

2

REF: p. 330

is required to manage laser risks and define safety protocols. licensed staff member laser safety officer committee patient advocate

ANS: B The laser safety officer is required to manage laser risks and define safety protocols.

DIF:

2

REF: p. 341

13. All personnel entering a room in which a laser is in use must a. wear the appropriate eye protection b. sign the laser log c. wear a lead apron d. both B and C

.

ANS: A All personnel entering a room in which lasers are in use must wear protective eyewear.

DIF:

2

REF: p. 341

14. Protection of the patient during laser surgery would include a. wet towels b. protective eyewear c. matte-finish metal airways d. both A and B

.

ANS: D All patients undergoing laser surgery while awake wear protective eyewear. Wet towels are placed around the operative site to prevent burns at the operative site.

DIF:

2

REF: p. 342

15. The determines the degree of thermal damage from the laser. a. sensitivity of the irradiated tissue b. amount of tissue affected c. length of time tissue is exposed d. all of the above

SOURCE: Browsegrades.net

ANS: D The following criteria determine the degree of thermal damage: • The sensitivity of the irradiated tissue • The amount of tissue affected • The wavelength of the laser beam • The energy level of the laser beam • The amount of time the tissue is exposed DIF:

2

REF: p. 342

16. The two most common injuries associated with unintentional laser exposure are . a. eye injury and tissue burn b. infertility and genetic mutation c. infection and allergies d. infection and wound dehiscence ANS: A The two most common injuries associated with unintentional laser exposure are eye injury and skin burn. Lasers in the ultraviolet and infrared areas of the spectrum are the most damaging.

DIF:

2

REF: p. 341

17. Cryosurgery is the use of an extremely a. heavy b. bright c. hot d. cold

instrument or substance to destroy tissue.

ANS: D Cryosurgery is the use of an extremely cold instrument or substance to destroy tissue.

Cryosurgery has been used for many years for the treatment of small skin lesions. Liquid nitrogen is applied to tissue, which freezes almost immediately and eventually sloughs.

DIF:

2

REF: p. 338

18. In laser surgery a method of intermittent application of the laser light on the target tissue is called . a. laser medium b. pulsed wave c. parallel d. wavelength ANS: B In laser surgery, pulsed wave is a method of intermittent application of the laser light on the target tissue.

DIF:

2

REF: p. 329

SOURCE: Browsegrades.net

19.

uses an intensely hot, precisely focused light beam to cut and coagulate tissue. a. Electrosurgery b. Laser surgery c. Cryosurgery d. Argon surgery ANS: B Laser is an acronym for light amplification by stimulated emission of radiation. Laser surgery uses an intensely hot, precisely focused beam of light to cut and coagulate tissue.

Electricity does not pass through the patient during laser use.

DIF:

20.

2

REF: p. 338

is a characteristic of laser light in which the frequency of each wave is the same. a. Monochromatic b. Monopolar circuit c. Excimer d. Coherency ANS: A All the waves in the laser have exactly the same length and are therefore monochromatic.

DIF:

2

REF: p. 339

21. The grounding pad that is aN pplR ied I to thGe pB ati. enCt toMcarry electrical current flow from the patient back to the power uniU t is S knoN wn T as the O electrode. a. dispersive b. active c. bovie d. ESU ANS: A The return electrode is also known by a number of different terms. These include dispersive electrode, inactive electrode, neutral electrode, or grounding pad.

DIF:

2

REF: p. 332

22.

is the term for complete destruction of tissue. a. b. c. d.

Alternative site burn Ablation Fulguration Coagulation

ANS: B Ablation is the complete destruction of tissue.

DIF:

2

REF: p. 328

SOURCE: Browsegrades.net

23. The gas, liquid, or solid through which light energy is passed to create a laser beam, contained within the optical resonant chamber, is known as . a. the laser medium b. solid state c. capacitive coupling d. coherency ANS: A The distinctive characteristics of laser energy are created when light is pumped into a sealed chamber and filled with a medium—a gas, solid, or liquid (called the laser medium). This chamber is called the optical resonant cavity.

DIF:

2

REF: p. 339

24. In laser technology, a series of mirrors that reflects photons or free electrons within the optical resonant chamber and causes emission of more photons and the creation of laser energy is known as . a. radiant exposure b. amplification c. selective absorption d. coherency ANS: B When photons of a specific energy enter the chamber, they stimulate the high-energy atoms in the chamber to vibrate or resonate in the same wave pattern. Mirrors in the laser system bounce the photons back and forth through the laser medium in the chamber. This increases the number of resonating pN aralR lel pIhotG ons.BT.hC is isMcalled amplification.

U S N T

DIF:

2

O

REF: p. 339

25. The destruction of cataracts using ultrasound technology is called a. ablation b. phacoemulsification c. coagulation d. fulguration

.

ANS: B Phacoemulsification is a process that uses a delicate ophthalmological instrument (phacoemulsifier) that uses ultrasonic energy for the destruction of cataracts.

DIF:

2

REF: p. 338

26. In electricity, the periodicity of electromagnetic waves is called a. amplitude b. frequency c. wavelength d. current ANS: B In electricity, frequency is the periodicity of electromagnetic waves.

SOURCE: Browsegrades.net

.

DIF: 27.

2

REF: p. 330

energy is created when electricity is transformed into mechanical energy to high-frequency vibration and friction. a. Ultrasonic b. Kinetic c. Cold thermal d. Magnetic ANS: A Ultrasonic energy is created when electricity is transformed into mechanical energy to high-frequency vibration and friction. The ultrasonic instrument simultaneously cuts and coagulates tissue by transmitting ultrasonic wave energy through specially designed forceps, scissors, or blades.

DIF:

2

REF: p. 338

28. All of the waves in laser light have exactly the same length and therefore are . a. colorless b. monochromatic c. red d. white ANS: B All the waves in the laser have exactly the same length and are therefore monochromatic.

DIF:

2

N R I G B.COM

REF: Up. 3S39N T

29. Lasers are distinguished by the functional or biophysical reaction of the a. target tissue b. laser energy c. radiant exposure d. delivery system

.

ANS: A Lasers are distinguished by the functional or biophysical reaction of the target tissue.

DIF: 30.

2

REF: p. 340

is a characteristic of laser energy in which some cells absorb the lasing medium whereas others do not. This characteristic prevents the spread of heat (and damage) outside the target tissue. a. Radiant exposure b. Selective absorption c. Direct coupling d. Capacitive coupling ANS: B

SOURCE: Browsegrades.net

Selective absorption is an important characteristic of laser energy. This means that some cells absorb the lasing medium whereas others do not. This characteristic prevents the spread of heat (and damage) outside the target tissue.

DIF:

2

REF: p. 340

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Active electrode b. Patient return electrode 1. To prevent alternate site burns, the current exits the body through this highly conductive electrode.

2. Its function is to capture electrical current from the active electrode and transmit it back to the power unit.

3. Electrosurgical handpiece or pencil 4. Current must exit the body to complete the electrical circuit 5. It may be activated by a switch located on the pencil or by a foot pedal 6. Open procedures require tips such as a flat blade, Teflon-coated blade, needle point, ball tip, and loop.

7. Do not place in a position that might cause the return current to cross other bioelectrical devices such as a pacemaker.

8. Do not position over a scar or prominent bony surface 9. Endoscopic procedures reqN uiU reRloSnI g,NthGiT nB ele.cC troOdM es that can be inserted through a cannula 10. Stored in sealed packages to keep the gel moist 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS:

B B A B A A B B A B

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 332 p. 332 p. 332 p. 332 p. 332 p. 332 p. 337 p. 333 p. 332 p. 333

SOURCE: Browsegrades.net

Chapter 18: Moving, Handling, and Positioning the Surgical Patient Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Moving the arms away from the body is called a. adduction b. hyperextension c. abduction d. hyperflexion

.

ANS: C Moving the arms away from the body is called abduction.

DIF:

2

REF: p. 344

2. The position is a type of prone position in which the patient lies on his or her abdomen with the hips flexed into an inverted “V” position. a. Fowler b. prone c. jackknife or Kraske d. dorsal recumbent ANS: C The jackknife or Kraske position is a type of prone position in which the patient lies on his or her abdomen with the hiN ps fR lexeI d inG to aB n. inC verM ted “V” position.

U S N T

DIF:

2

O

REF: p. 369

3. Injuries are reduced when health care providers use a. proper body mechanics b. restraints c. lower back muscles when lifting patients d. the stretcher to open a door

.

ANS: A Injuries are reduced when health care providers use proper body mechanics.

DIF:

2

REF: p. 370

4. To assist the patient when falling, . a. try to hold the patient up b. keep your feet close together and knees straight c. ease the patient to the floor, while protecting his or her head d. once the patient is on the floor, seek help ANS: C To assist the patient when falling, ease the patient to the floor, while protecting his or her head.

SOURCE: Browsegrades.net

DIF: 5. a. b. c. d.

2

REF: p. 354

must be lower than the patient’s body at all times.

Bed rails The head of the bed The extension boot on an orthopedic table Drainage collecting units

ANS: D Drainage collecting units (such as urinary or chest units) must remain lower than the patient’s body at all times, and IV lines should be higher than the patient’s body.

DIF: 6. a. b. c. d.

2

REF: p. 349

must be higher than the patient’s body.

Drainage bags Intravenous (IV) lines and fluid The room temperature Both B and C

ANS: B Drainage collecting units (such as urinary or chest units) must remain lower than the patient’s body at all times, and IV lines should be higher than the patient’s body. Secure IV bags and other drainage units to the gurney.

DIF:

2

REF: p. 349

N R I G B.C M

7. When passing through manuU allyS opeN rateT d doorsOwhile transporting a patient, . a. push the foot of the stretcher forward against the door to open it b. open the doors first and secure them open c. always wait for someone to come through the door to help you d. shout for someone to help you ANS: B When passing through manually operated doors while transporting a patient, open the doors first and secure them open.

DIF:

2

REF: p. 350

8. Caregivers may accompany a(n) anesthesia induction. a. combative b. trauma c. unresponsive d. pediatric

patient to the surgical suite and stay through

ANS: D Caregivers may accompany a pediatric patient to the surgical suite and stay through anesthesia induction.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 354

9. The developmental age of the a. child b. child’s caregiver c. anesthesia care provider d. person transporting the child

is critical for communication to be effective.

ANS: A The developmental age of the child is critical for communication to be effective.

DIF:

2

REF: p. 355

10. An important element for the safety of the patient during positioning is necessary to provide smooth, step-by-step coordination. a. spur-of-the-moment decision making b. teamwork c. to always make the patient move herself or himself d. music

. It is

ANS: B An important element for the safety of the patient during positioning is teamwork. It is necessary to provide smooth, step-by-step coordination.

DIF:

2

REF: p. 346

11. Sequential compression deN viceR s arI e usG ed oBn.pC atieM nts having surgery to prevent U S N T O a. blood flow b. nerve damage c. muscle cramps d. blood pooling

.

ANS: D Sequential compression devices are used on patients having surgery to prevent blood pooling.

DIF:

2

REF: p. 361

12. The use of a footboard for the patient in the reverse Trendelenburg position may prevent the patient from sliding downward, which can cause . a. shearing injury b. vascular shift c. compartmental syndrome d. hypotension ANS: A The use of a footboard for the patient in the reverse Trendelenburg position may prevent the patient from sliding downward, which can cause shearing injury.

DIF:

2

REF: p. 362

SOURCE: Browsegrades.net

13. The surgical team may begin positioning the patient only after the permission. a. anesthesia care provider b. surgeon c. surgical technologist d. perioperative nurse

__ gives his or her

ANS: A The surgical team may begin positioning the patient only after the anesthesia care provider gives his or her permission.

DIF:

2

REF: p. 357

14. The position, or foot-down position, is used when the surgeon requires unobstructed access to the upper abdominal cavity and lower esophagus. a. reverse Trendelenburg b. Trendelenburg c. Fowler’s d. semi-Fowler’s ANS: A The reverse Trendelenburg position, or foot-down position, is used when the surgeon requires unobstructed access to the upper abdominal cavity and lower esophagus.

DIF:

2

REF: p. 362

15. Lying with the abdomen doNwnR warI d, thGe pB at. ienCt isMin the U S N T O a. supine b. prone c. lithotomy d. lateral

position.

ANS: B A number of variations of the prone position are used to allow access to the spine, cranium, and perianal region.

DIF:

2

REF: p. 368

16. A sitting position used for cranial, facial, and some reconstructive breast procedures is called the position. a. Fowler b. semi-Fowler c. Trendelenberg d. reverse Trendelenberg ANS: A A sitting position used for cranial, facial, and some reconstructive breast procedures is called the Fowler position.

DIF:

2

REF: p. 366

SOURCE: Browsegrades.net

17. Injuries are reduced when health care providers a. lift using the muscles of their lower back b. use proper body mechanics c. do not bend hips d. use sudden, jerky movements

.

ANS: B Proper body mechanics can reduce injuries in health care workers.

DIF:

2

REF: p. 370

18. When moving a patient, keep feet a. well apart b. close together c. in a narrow stance d. touching each other

_ to provide a wide base of support.

ANS: A When moving a patient, keep feet well apart to provide a wide base of support.

DIF:

2

REF: p. 346

19. A safety strap should be placed between the patient and the strap. a. directly on the patient’s skin with two finger’s space b. on top of a blanket or sheet with three finger’s space c. directly on the patient’s skin with three finger’s space d. on top of the blanket orNsheR et wIithG fouB r f. inC gerM ’s space

U S N T

O

ANS: B A safety strap should be placed on top of a blanket or sheet with three finger’s space between the patient and the strap.

DIF:

2

REF: p. 347

SOURCE: Browsegrades.net

Chapter 19: Surgical Skin Preparation and Draping Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The drape is used for procedures of the nose and throat. It protects the eyes during surgery and provides a sterile barrier over the head. a. lithotomy b. extremity c. head d. incise ANS: C The head drape is used for procedures of the nose and throat. It protects the eyes during surgery and provides a sterile barrier over the head DIF:

2

REF: p. 396

2. Surgeons use to hold the towels in place when draping the patient. a. nonpenetrating towel clamps b. surgical tape c. penetrating towel clamps d. Esmarch bandages ANS: A Surgeons use nonpenetratinNg toRweI l claG mpB s t. oC holdMthe towels in place when draping the

U S N T

patient.

DIF:

2

O

REF: p. 393

3. When draping the patient for surgery, once a towel or drape has been placed on the patient, . a. do not shift or move it b. it may be moved once c. it must be secured d. the skin prep is then performed ANS: A When draping the patient for surgery, once a towel or drape has been placed on the patient, do not shift or move it.

DIF:

2

REF: p. 391

4. When prepping the abdomen for surgery, what should you do first? a. Prep the incision site. b. Start at the nipple line and work downward. c. Clean the umbilicus with swabs, and then begin at the incision site. d. Begin at sides of body and work inward.

ANS: C

SOURCE: Browsegrades.net

When prepping the abdomen for surgery, clean the umbilicus with swabs, and then begin at the incision site.

DIF:

2

REF: p. 380

5. A(n) requires a preparation boundary that encompasses the neck, shoulder of the affected side, thorax to the operating table surface, and mid-pelvic region. a. appendectomy b. radical mastectomy c. pelvic laparoscopy d. shoulder procedure ANS: B A radical mastectomy requires a preparation boundary that encompasses the neck, shoulder of the affected side, thorax to the operating table surface, and mid-pelvic region.

DIF:

2

REF: p. 382

6. Any area that is highly colonized with microorganisms, such as a colostomy area, is prepped . a. from dirty area to clean area b. according to the surgeon’s preference c. with fresh sponges after the surrounding area is prepped d. according to the manufacturer’s instructions on the prep solution ANS: C Any area that is highly colonized with microorganisms, such as a colostomy area, is prepped N urro RSund INing GTarea B.C M with fresh sponges after the sU isO prepped.

DIF:

2

REF: p. 380

7. During coronary artery bypass graft surgery, the saphenous vein is often removed and used to replace the coronary vessel. How is the patient prepped for this procedure? a. The leg and thorax are prepped at the same time. b. It depends on the prep solution used. c. The leg and thorax are prepped separately, using a different setup for each site. d. Only the thorax is prepped.

ANS: C During coronary artery bypass graft surgery, the saphenous vein is often removed and used to replace the coronary vessel. The leg and thorax are prepped separately, using a different setup for each site.

DIF:

2

REF: p. 378

8. The purpose of draping is to provide a. exposure b. a wide sterile area c. a protective barrier d. warmth for the patient

around the surgical site.

SOURCE: Browsegrades.net

ANS: B The purpose of draping is to provide a wide sterile area around the surgical site.

DIF: 9. a. b. c. d.

2

REF: p. 386

result(s) when preparation solutions are allowed to pool underneath the patient.

Nosocomial infections Contaminated areas Residual activity Chemical burns

ANS: D Chemical burns result when prep solutions are allowed to pool underneath the patient.

DIF:

2

REF: p. 380

10. The most common prep solution for ophthalmic procedures is a. chlorhexidine b. duraprep c. dilute povidone-iodine d. alcohol

.

ANS: C Dilute (5% or less) povidone-iodine is the most common solution used in eye preps.

DIF:

2

REF: p. 380

N R I G B.C M

11. Urinary catheterization is a sU terilS e prN oceT dure. CoOntaminants introduced by catheterization increase the risk of . a. urinary retention b. infection c. bladder distension d. mucosal abrasions ANS: B Urinary catheterization is a sterile procedure. Contaminants introduced by catheterization increase the risk of infection.

DIF: 12.

2

REF: p. 375-376

is/are generally not removed from the surgical patient but will require a surgeon’s order if it needs to be done. a. Body piercings b. Hair c. Makeup d. Medical alert bracelets ANS: B Hair clipping requires a verbal or written order by the surgeon.

DIF:

2

REF: p. 377

SOURCE: Browsegrades.net

13. a. b. c. d.

is the body’s primary defense against infection.

Skin Immune system Hair Hygiene

ANS: A Skin is the body’s primary defense against infection.

DIF:

2

REF: p. 376

14. A cause of is the normal skin bacteria of the patient and the surgical team members being introduced into the incision. a. chemical burns b. desiccation c. strike-through contamination d. surgical site infections (SSI) ANS: D A cause of SSI is the normal skin bacteria of the patient and the surgical team members being introduced into the incision.

DIF:

1

REF: p. 391

15. A catheter is the most common catheter used during a surgical procedure for continuous drainage of the N bladRderI . G B.C M U S N T O a. Foley b. straight c. intravascular d. suprapubic ANS: A A Foley catheter is the most common catheter used during a surgical procedure for continuous drainage of the bladder.

DIF:

1

REF: p. 373

16. Before surgery, the skin must be washed or painted with a(n) to reduce the number of transient and normal microorganisms to an absolute minimum. a. disinfectant b. antiseptic solution c. sterile solution d. hand soap ANS: B Before surgery, the skin must be washed or painted with an antiseptic solution to reduce the number of transient and normal microorganisms to an absolute minimum.

DIF:

1

REF: p. 379

SOURCE: Browsegrades.net

17. a. b. c. d.

must never be shaved because of the failure to regrow or abnormal regrowth.

Eyebrows Facial hair Arm hair Pubic hair

ANS: A Eyebrows must never be shaved because of the failure to regrow or abnormal regrowth.

DIF:

1

REF: p. 377

18. When the skin is prepped correctly the area is antiseptically cleansed in what manner? a. Incision site to periphery b. Periphery to incision site c. Top of incision to bottom of incision line d. Bottom of incision line to top of incision line ANS: A The prep is performed in a circular or spiral pattern starting at the incision site and reaching the periphery.

DIF:

1

REF: p. 379

19. Only are approved for use on skin and may be used for the surgical skin prep. a. antiseptics b. disinfectants c. sterile solutions d. betadine solutions ANS: A Antiseptics used for the surgical prep are mainly evaluated according to the following criteria: (1) effectiveness on microbes, especially gram-negative and gram-positive bacteria; (2) possible or actual toxicity; (3) ability to use in or around the eyes, ears, mucous membranes, and neural tissue; (4) flammability; and (5) residual antimicrobial action after application.

DIF: 20. a. b. c. d.

1

REF: p. 377

drapes are used whenever laser surgery is planned.

Water-soaked Aluminum-coated Flame retardant light-reflecting

ANS: B Aluminum-coated drapes are used whenever laser surgery is planned. These deflect laser energy and prevent ignition in an oxygen-rich environment, especially in head and neck surgery.

DIF:

1

REF: p. 391

SOURCE: Browsegrades.net

21. If an area of the drape is suspected of being contaminated, the area may be a. covered with another impervious drape b. removed by the sterile person c. ignored if 1/2inch away from incision site d. removed by a nonsterile person

.

ANS: A Strike-through contamination occurs when a drape becomes soaked during surgery and solution penetrates to a nonsterile surface. Whenever possible, use only impervious drapes.

DIF:

1

REF: p. 391

22. Uncontrolled or unmonitored systems create a risk of a. allergies b. chemical burn c. fire d. thermal burn

.

ANS: D Uncontrolled or unmonitored systems create a risk of thermal burns because the exact temperature is not known.

DIF:

2

REF: p. 380

23. Surgical prep agents can cause skin irritation, rash, or other a. allergies b. chemical burn c. fire d. thermal burn

.

ANS: A Surgical prep agents can cause skin irritation, rash, or other allergies.

DIF:

2

REF: p. 380

24. Alcohol and alcohol-based prep solutions are volatile and flammable. When alcohol solution or volatile fumes come in contact with heat sources, they can easily cause _ . a. allergies b. chemical burn c. fire d. thermal burn ANS: C Alcohol and alcohol-based prep solutions are volatile and flammable. When alcohol solution or volatile fumes come in contact with heat sources, they can easily cause a fire on or inside the patient.

DIF:

2

25. Serious during surgery.

REF: p. 380 can occur when prep solutions are allowed to pool under the patient

SOURCE: Browsegrades.net

a. b. c. d.

allergies chemical burns fires thermal burns

ANS: B Serious chemical burns can occur when prep solutions are allowed to pool under the patient during surgery.

DIF:

2

REF: p. 380

26. During the cleansing process, the surgeon removes all foreign material and trims away devitalized tissue called . a. trauma b. cardiovascular c. autograft d. debridement ANS: D Trauma procedures may require debridement and removal of embedded foreign material as part of the prep, or just before it, with the patient under sedation.

DIF:

2

27.

REF: p. 386 is a type of tissue that is removed from one site on the patient and grafted

to another site. a. Trauma b. Cardiovascular c. Autograft d. Debridement ANS: C A tissue autograft is a graft that is removed from one site on the patient and grafted to another site.

DIF: 28.

2

REF: p. 386

wounds are almost always contaminated because they are caused by external forces and often occur in environments that are mildly or grossly contaminated. a. Trauma b. Cardiovascular c. Autograft d. Debridement ANS: A Trauma wounds are almost always contaminated because they are caused by external forces and often occur in environments that are mildly or grossly contaminated.

DIF:

2

REF: p. 386

SOURCE: Browsegrades.net

29.

are folded in a specific way before sterilization so that they can be positioned over the operative site and unfolded in a way that prevents contamination. a. Prep b. Gowns c. Drapes d. All of the above ANS: C Drapes are folded in a specific way before sterilization so that they can be positioned over the operative site and unfolded in a way that prevents contamination.

DIF:

2

REF: p. 386

30. The patient is ready for skin prep and draping only after a. induction of general anesthesia and intubation b. the “time out” c. the circulator has finished the required surgical paperwork d. the surgeon inspects the patient’s surgical site skin

.

ANS: A After the patient is under anesthesia and is intubated, the patient is then ready for the skin prep and draping.

DIF:

2

REF: p. 373

31. A retention catheter with a small, inflatable balloon at the tip is called a a. Robinson b. Malcot c. Fogarty d. Foley

catheter.

ANS: D Foley is a type of urinary catheter that remains in place. It is also called an indwelling catheter.

DIF:

2

REF: p. 373

32. Selection of the correct catheter is based on the patient’s a. age, mental development, and sexual preference b. age, size, and the type of procedure c. age, size, and gender d. size, grade in school, and gender

.

ANS: C Selection of the correct catheter is based on the patient’s age, size, and gender.

DIF:

2

REF: p. 373

33. Catheterization of a female surgical patient requires the a. supine b. prone

SOURCE: Browsegrades.net

position.

c. lithotomy d. knees slightly flexed ANS: D A female patient is positioned with the knees slightly flexed and the hips externally rotated.

A male patient is placed in the supine position for catheterization.

DIF:

2

REF: p. 374

34. Which of the following statements is true regarding the technique for placing a Foley catheter? a. The assisting hand does not contact sterile supplies, including the catheter itself. b. Both hands must remain sterile for the procedure. c. If the catheter is placed before the prep has been done, it is not done using aseptic technique. d. The insertion hand does not contact sterile supplies.

ANS: A The assisting hand does not contact sterile supplies, including the catheter itself. The insertion hand remains sterile and is used to cleanse the area and guide the catheter into place.

DIF:

2

REF: p. 374

MATCHING

IaNtcGhTthBem .CwO Choose from the terms listeNdUaR ndSm ithMtheir most correct description. You may use the same answer more than once. a. Before skin prep b. After skin prep c. During skin prep 1.

2.

3.

4.

5.

Place towels around surgical site Clip hair Administer anesthesia Blot dry with a sterile towel Wash off gross contamination

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

B A A C A

DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3

REF: REF: REF: REF: REF:

p. 387 p. 377 p. 373 p. 379 p. 379

SOURCE: Browsegrades.net

Chapter 20: Case Planning and Intraoperative Procedures Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The containing towels, drapes, and gowns is centered on the back table and opened using aseptic technique. a. wrapped basin b. instrument tray c. basic pack d. surgical drape ANS: C The basic pack containing towels, drapes, and gowns is centered on the back table and opened using aseptic technique.

DIF:

2

2. Using a(n) a. nonstressful b. educated c. surgical d. methodical

REF: p. 408 approach to all setups improves efficiency.

ANS: D Using a methodical approaN ch toRallIsetG upsB im .pCrovMes efficiency and greatly decreases stress U S N T O and errors in the learning phase.

DIF:

2

REF: p. 410

3. Before organizing and preparing supplies during setup, a. dry top b. increase the size of c. decrease the size of d. remove supplies from

the sterile area.

ANS: B Before organizing and preparing supplies, increase the size of the sterile area.

DIF:

2

REF: p. 410

4. Avoid shifting items around from one place to another during setup. Try to handle an item only once. Shifting items from one location to another without purpose increases the chance of and is not productive. a. injury b. confusion c. contamination d. missing items ANS: C

SOURCE: Browsegrades.net

Avoid shifting items around from one place to another during setup. Try to handle an item only once. Shifting items from one location to another without purpose increases the chance of contamination and is not productive.

DIF:

2

REF: p. 410

5. You may have up to 10 trays on a complex case. This is why it is important to think about what you need, locate it among all the supplies, and then put it in a specific place. If instrument trays must be stacked, place the ones on the bottom. a. least-used b. heavier c. empty d. large ANS: B Heavier trays are stacked on the bottom.

DIF: 6. a. b. c. d.

2

REF: p. 413

is/are responsible for ensuring that no item is left in a patient.

Licensed professionals only The certified surgical technologist The surgeon All team members

ANS: D All team members are responsible for ensuring that no item is left in a patient. The scrubbed N RtorInNorm GTally B.C M technologist or nurse and circUulaS peO rform the count together. In turn, they report the count to the surgeon, whether it is correct or incorrect.

DIF:

2

REF: p. 415

7. The count is performed by two people. Professional standard for counts as published by AORN requires a and another health care worker such as the surgical technologist to perform the count. a. circulator b. surgeon c. surgical assistant d. licensed practical nurse ANS: A The scrubbed technologist or nurse and the circulator normally perform the count together.

DIF:

2

REF: p. 415

8. Inadequate lighting increases needed. a. the procedure length b. tension in the surgical suite c. the risk of error

. The surgical technologist adjusts lights as

SOURCE: Browsegrades.net

d. patient’s time under anesthesia ANS: C Inadequate lighting increases the risk of surgery errors. The surgical technologist adjusts lights as needed. Overhead lights produce a small, shadowless beam that spreads peripherally to focus on a large or small area as needed.

DIF:

2

REF: p. 418

9. All sharps should be passed with . If hospital policy or an individual surgeon has not implemented this technique, the scrub must pass sharps in the traditional manner. a. the technique requested on surgeon’s preference card b. care c. the left hand d. a neutral zone (no-hands) technique ANS: D All sharps should be passed with a neutral zone technique. If hospital policy or an individual surgeon has not implemented this technique, the scrub must pass sharps in the traditional manner. The neutral zone is a physical location on the sterile field designated and understood by the surgical team as a physical space (basin or magnetic board) where sharps are placed and retrieved.

DIF:

2

REF: p. 416

10. The surgical technologist must keep track of the amount of N dRloSssIcNanGbTeB.C M wound so that estimated blooU calcuO lated. a. lap sponges b. Raytec c. irrigation fluid d. local anesthetic

used in the

ANS: C The surgical technologist must keep track of the amount of irrigation fluid used in the wound so that estimated blood loss can be calculated.

DIF:

2

11. Two types of anaerobic. a. biopsies b. x-rays c. images d. bacterial cultures

REF: p. 413 are commonly taken during surgery. These are aerobic and

ANS: D Two types of bacterial cultures are commonly taken during surgery: aerobic and anaerobic.

Each requires a designated type of transfer tube. Anaerobic sampling can be performed with a needle and syringe or using a Dacron swab as described earlier.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 423

12. Any tissue or item removed from the patient’s body during surgery is maintained in a specific way on the surgical field to prevent loss or damage. a. always saved for the patient b. counted c. biohazard waste d. a specimen

and is

ANS: D Any tissue or item removed from the patient’s body during surgery is a specimen and is maintained in a specific way on the surgical field to prevent loss or damage.

DIF:

2

REF: p. 420

13. The is responsible for maintaining an organized and safe surgical field. a. surgical technologist b. CST-CFA certified first assistant c. surgeon d. anesthesia provider ANS: A The surgical technologist is responsible for maintaining an organized and safe surgical field.

DIF:

2

REF: p. 403

14. The process preceded by paNtienRt veIrifiG catiB on.pC rocM ess detailed by The Joint Commission is U S N T O called . a. assignment board b. TIMEOUT c. sentinel event d. assessment ANS: B The surgical TIMEOUT (universal protocol) has been developed in response to the high rate of wrong site and wrong patient surgeries. The protocol is specific, precise, and mandatory in all accredited health facilities.

DIF:

1

REF: p. 418

15. Removal of a sample of tissue for pathological analysis is called a a. culture b. biopsy c. prep d. diagnosis

.

ANS: B Tissue biopsy is the removal of tissue or cells for gross identification and microscopic analysis. Microscopic analysis results in a definitive diagnosis, such as malignancy, or is used to determine the nature of an abnormality. Biopsy is performed during endoscopic, image-guided surgery, or as part of an open procedure.

SOURCE: Browsegrades.net

DIF:

1

REF: p. 400

16. A tissue implant derived from another person, animal, or the patient is called a(n) . a. graft b. implant c. dissection d. section ANS: A A tissue implant derived from another person, animal, or the patient is called a graft. An implant is used to replace or augment existing tissue. A graft may be obtained from the patient, another person, an animal source, or synthetic or biosynthetic materials.

DIF:

1

REF: p. 400

17. A method used for gathering supplies for a case is referred to as a(n) a. assignment board b. case cart c. protocol d. event related

system.

ANS: B A method used for gathering supplies for a case is referred to as a case cart system.

DIF:

1

REFN : pR . 40I 6-4G 07 B.C M

U S N T

O

18. A(n) is a database containing each surgeon’s particular routines for specific instruments for a particular surgery. a. surgeon’s preference card b. assignment board c. case plan d. Universal Protocol ANS: A A surgeon’s preference card is a database containing the surgeon’s particular routines for specific instruments for a particular surgery.

DIF:

2

REF: p. 407

19. Gathering needed diagnostic studies, such as radiographs, magnetic resonance images, or other data the surgeon needs during the case is part of . a. preparing the room b. terminal cleaning c. sterile setup d. Universal Protocol ANS: A Gathering needed diagnostic studies, such as radiographs, magnetic resonance images, or other data the surgeon needs during the case is part of preparing the room.

SOURCE: Browsegrades.net

DIF: 20.

1

REF: p. 407

are not brought to the Mayo stand until the superficial wound layers are closed and the final sponge counts have been completed. a. Dressings b. Moist Raytecs c. Implants d. Sharps ANS: A Dressings are not brought to the Mayo stand until the superficial wound layers have been closed and the final sponge counts have been completed.

DIF:

1

REF: p. 424

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Surgical technologist b. Circulator/registered nurse c. Surgeon 1. The wound is then closed according to his or her protocol.

2. Must keep track of all counted items throughout a surgical procedure. He or she must know what kind and how many itN em nsG idT eB th. eC paOtiM ent at any point during the procedure.

UsRaSreIiN 3. Responsible for maintaining an organized and safe surgical field.

4. Receives the specimen from the sterile field in a designated container.

5. Handling and passing instruments are important tasks of this person.

6. When blood loss must be estimated, he or she may be required to weigh each sponge.

7. Anesthesia begins only after he or she has arrived and is ready to scrub.

8. The anesthesia care provider and this person focus on preparing the patient for anesthesia.

9. If the count is incorrect, this person is notified and the count repeated.

10. Sharps are opened during the setup. This person opens the outer package and the scrubbed technologist removes them and places them in a sharps holder.

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS:

C A A B A B C B C B

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 424 p. 415 p. 418 p. 420 p. 403 p. 420 p. 410 p. 410 p. 415 p. 409

SOURCE: Browsegrades.net

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Preoperative b. Postoperative c. Intraoperative 11.

12.

13.

14.

15.

16.

17.

The patient is transferred to PACU (postanesthesia recovery unit) The scrub and the circulator open the case The patient arrives from the holding area and is transferred to the operating bed Specimens are documented and transported to a designated area for pickup The circulator continues to distribute sterile supplies as needed The scrub person performs hand antisepsis or scrub The surgical suite is cleaned and decontaminated for the next case

11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS:

B A A B C A B

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF:

p. 425 p. 408 p. 410 p. 425 p. 403 p. 408 p. 425

SOURCE: Browsegrades.net

Chapter 21: Management of the Surgical Wound Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. A a. b. c. d.

suture is a suture-needle combination designed to discharge the suture easily. double-armed spring-eye needle swaged suture-needle combination control-release

ANS: D A detachable suture is one in which the suture detaches from the needle by pulling it straight back from the swage. These are referred to by their proprietary names such as De-tach or Control-release.

DIF: 2.

2

REF: p. 440

dressings are used to prevent or limit movement of the surgical wound during healing. a. Flat b. Pressure c. Supportive d. None of the above ANS: C Supportive dressings are used to prevent or limit movement of the surgical wound during healing. Thick cotton covered with stretch gauze is used for soft support. Hard casting materials are used when complete immobility is required.

DIF:

2

REF: p. 457

3. The needle has a round body that narrows to a sharp point. It punctures tissue, making an opening for the body of the needle to follow. Its primary use is for suturing soft tissue. a. blunt b. tapered c. cutting d. spatula ANS: B The tapered needle has a round body that tapers to a sharp point. It punctures tissue, making an opening for the body of the needle to follow. Its primary use is for suturing soft tissue such as muscle, subcutaneous fat, peritoneum, and dura, as well as gastrointestinal, genitourinary, biliary, and vascular tissue.

DIF:

2

REF: p. 441

4. The process of suturing two tissue edges together is called

SOURCE: Browsegrades.net

.

a. b. c. d.

approximation ligation stitching locking

ANS: A The primary use of sutures is to repair or construct tissue. The process of suturing other means to hold two tissue edges together is called approximation. Suture is also used to tie or ligate bleeding vessels.

DIF:

2

REF: p. 442

5. A(n) suture is a continuous suture used to approximate the open ends of a lumen.

It is traditionally used during an appendectomy to close the base of the appendix after the distal portion is removed. a. interrupted b. running c. mattress d. purse-string ANS: D The purse string is a special continuous suture technique for closing the end of a tubular structure (lumen) such as the appendix, which is its most common application. In this technique, one end of the suture is anchored and stitches are placed around the periphery of the open “tube.”

DIF:

2

G B.C M U S N T O

REFN : pR . 44I 3

6. In areas where great strength is required, such as abdominal incisions, sutures are used in conjunction with routine abdominal suture layers to add support to the closure. a. retention b. continuous c. horizontal mattress d. vertical mattress ANS: A Retention sutures are a type of interrupted technique used to provide additional support to wound edges in abdominal surgery. In this technique, heavy sutures are placed through all the tissue layers of the body wall several centimeters from the primary suture line.

DIF:

2

REF: p. 435-445

7. When cutting sutures, use only scissors. To cut the suture, open the scissors slightly. Use only the tips of the scissors to cut; never the midportion of the blades. Cut only when you can see what you are cutting. a. tissue b. bandage c. sharp suture d. Potts ANS: C

SOURCE: Browsegrades.net

The proper technique for cutting sutures is as follows: • Use only sharp suture scissors; never use tissue scissors on suture material.

• To cut the suture, open the scissors slightly. Use the tip of the scissors to cut, because thisprovides more control.

• Place your index finger over the top of the scissors to steady the blades. Turn the scissors at a 45-degree angle. This creates a small “whisker.” Cut the suture ends while keeping the scissors at an angle.

• When cutting sutures and performing other tasks at the same time, “palm” the scissors in one hand.

• Remove any cut suture ends from the wound area to prevent them from falling into the wound.

DIF:

2

REF: p. 451

8. The ability of suture material to absorb fluid is called a. inert b. tensile strength c. enzymatic action d. capillary action

.

ANS: D Capillary action is the ability of suture material to absorb fluid. Sutures made of multifilament strands absorb moisture and hold body fluids (called wicking or capillary action).

DIF:

2

REF: p. 435-445

NURSINGTB.COM

9. The phase of wound healing is the proliferative stage. During this phase, fibroblasts synthesize collagen and other cell matrices. a. substrate b. lag c. remodeling d. second ANS: D The proliferative (second) phase occurs from the fourth or fifth day and continues for approximately 2 weeks. During this phase, fibroblasts synthesize collagen and other cell matrices. These form the ground substance of the new tissue, providing support and strength.

DIF:

2

REF: p. 461

10. Excess inflammation and serous discharge from the wound is a sign of surgical . a. site infection b. incision healing c. site dehiscence d. site drainage ANS: A

SOURCE: Browsegrades.net

The first signs of infection are excess inflammation and serous discharge from the wound.

At this stage medical and nursing personnel take immediate action to halt the process of infection.

DIF:

2

REF: p. 462

11. Which of the following is used to exsanguinate the limb before the pneumatic tourniquet is applied? a. Cotton material (Webril) b. Tourniquet cuff c. Esmarch d. Air bladder ANS: C An Esmarch bandage is wrapped distal to proximal to exsanguinate the limb before the pneumatic tourniquet is inflated.

DIF: 12. a. b. c. d.

2

REF: p. 431

will contribute to the healing process of the surgical incision.

Surgical technique Chronic disease Nutritional status All of the above

ANS: D Factors that affect wound healing are immune system, chronic disease, fluid and electrolyte N esit RSy,IaN Gand B.C M balance, nutritional status, obU ge, T surgOical technique.

DIF:

2

REF: p. 461-462

13. Surgical gut sutures are packaged in a(n) a. alcohol b. saline c. sterile water d. polybutelate

solution.

ANS: A Gut sutures are packaged in an alcohol solution.

DIF: 14.

2

REF: p. 436

is/are tubing through which retention sutures are threaded to prevent them from cutting into the patient’s skin. a. Penrose drain b. Bolsters c. Binders d. Montgomery straps ANS: B

SOURCE: Browsegrades.net

As each suture is drawn tight, it pulls the edges of the incision into approximation without cutting into the tissue. Plastic or rubber bolsters or small lengths of tubing are threaded through the suture to prevent it from cutting into the patient’s skin.

DIF:

2

REF: p. 445

15. A free-tie suture attached to the end of a clamp is called a a. deep tie b. clamp tie c. tie on a passer d. suture on a clamp

.

ANS: C A suture may be passed around a vessel or duct using a clamp. This type of tie is passed by securing one end to the end of the clamp. The clamp is passed in the normal manner but the suture length should be draped over the scrub’s hand in the same way a mounted needle is passed. If this type of tie is needed during a procedure, the surgeon may ask for a “tie on a passer” or simply a tie.

DIF:

2

REF: p. 447

16. A monofilament suture is extruded from the package and a. stretched slightly b. soaked in saline c. soaked in antibiotic solution d. coiled to increase tensile strength

.

ANS: A A monofilament is a single continuous fiber made of a polymer chemical (chains of the same molecule strung together) that is extruded and stretched slightly.

DIF:

2

REF: p. 435

17. Load the needle holder _ package. a. after b. before c. while d. never

removing the entire needle suture combination from the

ANS: B Load the needle holder before removing the entire needle suture combination from its package.

DIF:

2

REF: p. 447

18. Most commercial needles are now manufactured with the suture preattached. This is called a suture. a. Swage b. French eye

SOURCE: Browsegrades.net

c. monofilament d. braided ANS: A Most commercial needles are now manufactured with the suture preattached. This is called a Swage or atraumatic suture. The suture is inserted into the eye of the needle, and the area is crimped and sealed.

DIF:

2

19. The knot is the a. strongest b. weakest c. thickest d. thinnest

REF: p. 430 part of the suture.

ANS: B Suture material becomes 10% to 40% weaker when knotted.

DIF:

2

REF: p. 435

20. A suture that causes little or no bioactivity is said to be a. inert b. control-released c. active d. bio-balanced

.

ANS: A Sutures that cause little or no bioactivity are said to be highly inert, causing little or no inflammation.

DIF:

2

REF: p. 436

21. A suture-needle combination containing a needle at each end of the suture is called a suture. a. double-armed b. double-needle c. double-threaded d. double-hooked ANS: A Double-armed sutures are used on circular or tubular suture lines. When a double-armed suture is passed, only one needle is mounted on the needle holder.

DIF:

2

REF: p. 440

22. A suture with long suture length is anchored at one end of the tissues, and the needle alternated from one side of the tissue edge to the other the entire length of the wound. a. simple or interrupted b. continuous or running

SOURCE: Browsegrades.net

c. swaged d. braided ANS: B A continuous or running suture with a single long suture length is anchored at one end of the tissue, and the needle alternated from one side of the tissue edge to the other.

DIF:

2

REF: p. 443

23. When handling _, exercise caution to prevent puncturing your or a team member’s glove. a. stainless steel sutures b. disposable surgical staples c. burs d. rasps ANS: A Stainless steel suture requires special handling. It kinks easily, and the ends are needle sharp. The suture ends can puncture gloves, drapes, and other soft materials.

DIF:

2

REF: p. 437

24. How to position the needle holder in relation to the suture needle depends on whether the is right-handed or left-handed. a. surgeon b. surgical technologist c. circulator d. anesthesiologist ANS: A The position of the needle holder in relation to the suture needle depends on whether the surgeon is right-handed or left-handed. The long end of the suture should not come in contact with the surgeon’s palm. It may be draped over the scrub’s hand or allowed to hang downward.

DIF:

2

REF: p. 449

25. Surgeons are accustomed to receiving sutures from the scrub in a prescribed manner for . a. better utilization of the suture b. safety and efficiency of movement c. adhering to policy d. increasing infection control ANS: B One of the primary skills in surgical technology is the preparation and passing of sutures.

Surgeons are accustomed to receiving sutures from the scrub in a prescribed manner for safety and efficiency of movement.

DIF:

2

REF: p. 445

SOURCE: Browsegrades.net

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Wound complications b. Wound healing c. Wound classification 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Seroma and hematoma Inflammatory phase Evisceration Clean contaminated wound Contaminated wound Remodeling phase Adhesions Proliferative phase Clean wound Surgical site infection

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS:

A B A C C B A B C A

DIF: 3 REF: p. 463 DIF: 3 REF: p. 461 DIF: 3 REF: p. 463 DIF: 3 REF: p. 461 DIF:N 3 R EF: p. 461 G B. CF:M p. 461 R I U S N T 3 DIF: REO DIF: 3 REF: p. 463 DIF: 3 REF: p. 461 DIF: 3 REF: p. 461 DIF: 3 REF: p. 462-463

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Suture material b. Surgical needle characteristic c. Suturing technique 11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Tapered Running or continuous Conventional cutting Vicryl Polypropylene Interrupted Stainless steel French eye Subcuticular Suture ligature

SOURCE: Browsegrades.net

11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS: 18. ANS: 19. ANS: 20. ANS:

B C B A A C A B C C

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 441 p. 443 p. 441 p. 439 p. 435 p. 443 p. 435 p. 440 p. 443 p. 445

SOURCE: Browsegrades.net

Chapter 22: Minimally Invasive Endoscopic and Robotic-Assisted Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. After precleaning, a flexible endoscope must be _ a. flushed with saline b. sterilized c. soaked in enzymatic cleaner d. leak tested

.

ANS: D After precleaning, a flexible endoscope must be leak tested.

DIF:

2

REF: p. 483

2. A is used to assess the regional anatomy, to obtain tissue biopsies, and to perform minor surgical procedures. a. laparoscope b. rigid endoscope c. flexible endoscope d. rigid telescope ANS: C A flexible endoscope is used to assess the regional anatomy, to obtain tissue biopsies, and to perform minor surgical proN cedR uresI . G B.C M

U S N T

DIF:

2

O

REF: p. 481

3. The flexible tip of the endoscope is operated at the control head to obtain _ a. direct views b. rotational views c. biopsies d. washings

.

ANS: B The flexible tip of the endoscope is operated at the control head to obtain rotational views.

DIF:

2

REF: p. 481

4. Surgical are used in place of suture ligatures to occlude blood vessels or other types of hollow structures, such as the bile ducts. a. suture b. sponges c. clips d. clamps ANS: C Surgical clips are used in place of suture ligatures to occlude blood vessels or other types of hollow structures, such as the bile ducts.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 475

5. While cleaning, look for defects in the surface of the instrument. Look for any signs of instrument housing and damage that may cause accidental burns to the patient. a. insulation b. working tips c. finger rings d. grip mechanisms ANS: A While cleaning, look for defects in the surface of the instrument. Look for any signs of instrument housing and insulation damage that may cause accidental burns to the patient.

DIF:

2

REF: p. 482

6. To prevent damage to a telescope, you should never carry or hold it a. without a container b. with one hand c. by the head d. by the shaft

.

ANS: D To prevent damage to a telescope, you should never carry or hold it by the shaft.

DIF:

2

G B.C M U S N T O

REFN : pR . 46I 8

7. The clarity of an image that the camera provides depends on a. how many pixels or silicon units the camera chip contains b. the user’s knowledge and experience c. the quality of the video system d. the quality of overhead lighting

.

ANS: A The clarity of an image that the camera provides depends on how many pixels or silicon units the camera chip contains.

DIF:

2

REF: p. 469

8. The connects the camera to the telescope and is specific to the type of camera and scope in use. a. hard coupler b. endocoupler c. camera coupler d. duocoupler ANS: B The endocoupler connects the camera to the telescope and is specific to the type of camera and scope in use.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 469

9. When a fiberoptic cable is in use, it must not be activated until it is attached to the system.

The intense light rays can . a. cause serious eye damage to surgical personnel b. easily ignite the patient’s drapes c. restrict the surgical team member’s view d. cause the longitudinal fibers to break ANS: B When a fiberoptic cable is in use, it must not be activated until it is attached to the system.

The intense light rays can easily ignite the patient’s drapes.

DIF:

2

REF: p. 467

10. When the telescope is introduced into the body, the temperature difference creates on the telescope lens. a. clearness b. crystals c. cracks d. fogging ANS: D When the telescope is introduced into the body, the temperature difference creates fogging on the telescope lens.

DIF:

2

G B.C M U S N T O

REFN : pR . 46I 9

11. The proximal section of a flexible endoscope where the controls are located is called the . a. capacitator b. focus ring c. trocar d. control head ANS: D The proximal section of a flexible endoscope where the controls are located is called the control head.

DIF:

2

REF: p. 481

12. A(n) is used to create ports into the abdomen or other body cavities for the insertion of endoscopic instruments. a. trocar-cannula system b. insufflator c. uterine manipulator d. Veress needle ANS: A A trocar-cannula system is used to create ports into the abdomen or other body cavities for the insertion of endoscopic instruments.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 471

13. The viewer provides three-dimensional images of the surgical site when using the da Vinci system. a. monoscopic b. stereoscopic c. eye lens d. binocular ANS: B The stereoscopic viewer provides three-dimensional images of the surgical site when using the da Vinci system.

DIF: 14. A a. b. c. d.

2

REF: p. 487

is commonly performed with the patient in the lithotomy position. laparoscopic cholecystectomy laparoscopic hernia repair gynecological procedure thoracic procedure

ANS: C A gynecological procedure is commonly performed with the patient in the lithotomy position.

DIF:

2

G B.C M U S N T O

REFN : pR . 48I 0

15. MIS requires instruments and an a. long surgical; audio b. telescopic; imaging c. short surgical; open drainage d. no surgical; open drainage

system.

ANS: B MIS requires telescopic instruments and an imaging system.

DIF:

2

REF: p. 466

16. A traditional surgical procedure that includes incision and wide access to the targeted tissue is a(n) procedure. a. open b. minimally invasive c. closed d. reduced ANS: A A traditional surgical procedure that includes incision and wide access to the targeted tissue is an open procedure.

DIF:

2

REF: p. 466

SOURCE: Browsegrades.net

17. A a. b. c. d.

is needed to create a pneumoperitoneum. distractor Veress needle uterine sound dilator

ANS: B A Veress needle is needed to create a pneumoperitoneum.

DIF:

2

REF: p. 473

18. When endoscopic instruments are passed to the surgeon and the assistant, the working end of the instrument should be pointed toward the opening of the cannula or endoscope. a. downward b. upward c. away from the surgeon and d. away from the technologist and ANS: A When endoscopic instruments are passed to the surgeon and assistant, the working end of the instrument should be pointed downward toward the cannula’s or endoscope’s opening.

DIF:

2

REF: p. 480

19. During an endoscopic procN eduR re, tI he rG oomBl. igC hts M are usually O a. left on as brightly as possU ibleS N T b. dimmed or turned off c. adjusted per surgeon preference d. adjusted per circulator preference

for most of the case.

ANS: B During an endoscopic procedure, the room lights are usually dimmed or turned off for most of the case.

DIF: 20.

2

REF: p. 480

surgery combines the techniques of minimally invasive surgery with computer-guided instruments that are controlled remotely through a nonsterile interface system. a. Robotic b. Remote c. Computer-assisted d. Technology-enhanced ANS: A Robotic surgery combines the techniques of minimally invasive surgery with computer-guided instruments that are controlled remotely through a nonsterile interface system.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 483

21. During laparoscopy, the abdominal cavity is filled with carbon dioxide, which balloons the body wall outward. This process is called . a. insufflation b. arthroscopy c. inflation d. filing ANS: A During laparoscopy, the abdominal cavity is filled with carbon dioxide, which balloons the body wall outward. This process is called insufflation.

DIF:

2

REF: p. 473

22. Each silicon element in the chip represents one a. dimmer b. pixel c. meter d. resolution

.

ANS: B Each silicon element in the chip represents one pixel.

DIF: 23. a. b. c. d.

2

REF: p. 469

systems can beNdispRosaI bleG , reuB sa.bC le, oMr reposable.

U S N T O Trocar-cannula Specimen retrieval Fenestrated lumen Open drainage

ANS: A Trocar-cannula systems can be disposable, reusable, or reposable.

DIF: 24. a. b. c. d.

2

REF: p. 472

frequency bipolar electrosurgery is used to coagulate and cut through tissue.

HighLowModerateQuick-

ANS: A High-frequency bipolar electrosurgery is used to coagulate and cut through tissue.

DIF: 25.

2

REF: p. 479 and

modalities have replaced traditional sutures in many endoscopic

procedures. a. Electrosurgical; ultrasound

SOURCE: Browsegrades.net

b. Electrocardio; static c. Antistatic; static d. Septic; adaptive ANS: A Electrosurgical and ultrasound modalities have replaced traditional sutures in many procedures.

DIF:

2

REF: p. 475

26. After the leak test, the a. camera b. endoscope c. camera lens d. camera and endoscope case

is cleaned manually.

ANS: B After the leak test, the endoscope is cleaned manually.

DIF:

2

REF: p. 483

27. Among the new skills that surgeons must learn when using robotic surgery is the loss of feedback. a. haptic b. septic c. hepatic d. aseptic ANS: A Among the new skills that surgeons must learn is the loss of haptic feedback.

DIF:

2

REF: p. 485

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Minimally invasive surgery b. Flexible endoscopy c. Robotics 1.

2.

3.

4.

5.

Primary benefits include reduction of hand tremors and enhanced dexterity Procedures would include laparoscopy, pelviscopy, and arthroscopy Primary use is in diagnostic procedures Must be leak tested after precleaning Allows computer-aided manipulation of instruments

1. ANS: C 2. ANS: A 3. ANS: B

DIF: DIF: DIF:

3 3 3

REF: p. 484 REF: p. 480 REF: p. 492

SOURCE: Browsegrades.net

4. ANS: B 5. ANS: C

DIF: DIF:

3 3

REF: p. 483 REF: p. 483

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Instrument b. Technique c. Imaging d. Insufflation 6.

7.

8.

9.

10.

11.

12.

13.

14.

Trocar placement Probe Accomplished through a Veress needle Fiberoptic light cord High-resolution monitor Suction/irrigator Introduction of CO2 Tissue expansion Camera control unit

6. ANS: B 7. ANS: A 8. ANS: D 9. ANS: C 10. ANS: C 11. ANS: A 12. ANS: D 13. ANS: D 14. ANS: C

DIF: 3 REF: p. 472 DIF: 3 REF: p. 487 DIF: 3 REF: p. 473 DIF: 3 REF: p. 476 DIF: 3 REF: p. 467 N R I G B. DIF: U3 S N T RC EO F:M p. 481 DIF: 3 REF: p. 473 DIF: 3 REF: p. 473 DIF: 3 REF: p. 481

SOURCE: Browsegrades.net

Chapter 23: General Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The organs and organ systems that are included in general surgery are the following EXCEPT . a. spleen b. pancreas c. femur d. breast ANS: C The organs and organ systems involved include the following: abdominal wall, gastrointestinal system, biliary system, spleen, pancreas, hepatic system, and breast.

DIF:

2

REF: p. 494

2. RLQ refers to what part of the abdominal section? a. Right lower quality b. Right lower quadrant c. Right labile quality d. Right labile quadrant ANS: B RLQ stands for right lowerNquaRdraI nt. G

B.C M U S N T O

DIF:

2

REF: p. 494

3. LLQ refers to what part of the abdominal section? a. Left labile quadrant b. Left lower quadrant c. Left labile quality d. Left lower quality ANS: B LLQ stands for left lower quadrant.

DIF:

2

REF: p. 494

4. The abdomen is divided into nine regions; the organs located in the rib area is in the . a. left and right lumbar regions b. left and right iliac regions c. umbilical region d. left and right hypochondriac regions ANS: D The rib area is located in the left and right hypochondriac regions.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 496

5. The abdomen is divided into nine regions; the organ located in the inguinal area is in the . a. left and right lumbar regions b. left and right iliac regions c. umbilical region d. left and right hypochondriac regions ANS: B The inguinal area is located in the left and right iliac regions.

DIF:

2

REF: p. 496

6. The abdomen is divided into nine regions; the organ located in the umbilicus area is in the . a. left and right lumbar regions b. left and right iliac regions c. umbilical region d. left and right hypochondriac regions ANS: C The umbilicus is located in the umbilical region.

DIF:

2

REF: p. 496

7. All of the following are disN tincR t tisI sueG layeBrs.tC hat M support the viscera, EXCEPT U S N T O . a. fascia b. skin c. subcutaneous d. umbilicus ANS: D Tissue layers comprise the following: skin, subcutaneous, fascia, muscle, and peritoneum.

DIF:

2

REF: p. 495

8. The spermatic cord in the male follows the inguinal canal and contains the following structures, EXCEPT . a. spermatic fascia b. lymph nodes c. lymph vessels d. cremaster muscle ANS: B The spermatic cord in the male follows the inguinal canal and contains the following structures: spermatic fascia, cremaster muscle, genitofemoral nerve, ductus deferens, lymph vessels, and testicular vein and artery.

DIF:

2

REF: p. 497

SOURCE: Browsegrades.net

9. A midline incision is used for surgical procedures of the a. liver b. sigmoid colon c. appendix d. uterus

.

ANS: A A midline incision is made for surgical procedures of the lower esophagus, stomach, small intestine, liver, biliary system, spleen, pancreas, and proximal colon.

DIF:

2

REF: p. 498

10. A subcostal incision is used for surgical procedures of the a. spleen b. pancreas c. appendix d. uterus

.

ANS: A A subcostal incision is used for surgical procedures of the right biliary system, spleen, and bilateral (chevron).

DIF:

2

REF: p. 498

11. A McBurney incision is used for surgical procedures of the a. spleen b. pancreas c. appendix d. uterus

.

ANS: C A McBurney incision is used for surgical procedures of the appendix.

DIF:

2

REF: p. 498

12. An inguinal (oblique) incision is made for surgical procedures of the a. appendix b. spleen c. liver d. spermatic cord

.

ANS: D An inguinal incision is made for surgical procedures of the muscle and fascia of the inguinal abdominal wall, spermatic cord, inguinal ring, abdominal ring, and inferior epigastric artery and vein.

DIF:

2

REF: p. 498

13. A lower transverse abdominal incision is made for surgical procedures of the a. spleen

SOURCE: Browsegrades.net

.

b. pancreas c. appendix d. uterus ANS: D A lower transverse abdominal incision is made for surgical procedures of the uterus, adnexa, bladder, and access for cesarean sections.

DIF:

2

REF: p. 498

14. Protrusion of abdominal tissue through one or more abdominal layers is a(n) a. strangulated hernia b. direct inguinal hernia c. Spigelian hernia d. incisional hernia

.

ANS: D Incisional hernia is a protrusion of abdominal tissue through one or more abdominal layers.

DIF:

2

15. In a(n) squeezed. a. strangulated b. direct inguinal c. Spigelian d. incisional

REF: p. 503 hernia, tissue protruding from the hernia may be swollen and

ANS: A In a strangulated hernia, tissue protruding from the hernia may be swollen and squeezed.

DIF:

2

REF: p. 503

16. A hernia in which abdominal viscera slides into the inguinal canal from the deep inguinal ring is a(n) . a. strangulated hernia b. direct inguinal hernia c. indirect hernia d. incisional hernia ANS: C An indirect hernia is a hernia in which abdominal viscera slides into the inguinal canal from the deep inguinal ring.

DIF:

2

REF: p. 503

17. Protrusion of abdominal or inguinal tissue directly through the transversalis fascia is a(n) . a. strangulated hernia b. direct inguinal hernia c. indirect hernia

SOURCE: Browsegrades.net

d. incisional hernia ANS: B A direct inguinal hernia is a protrusion of abdominal or inguinal tissue directly through the transversalis fascia.

DIF:

2

REF: p. 503

18. A hernia arising from a weakness in the transverse fascia below the inguinal ligament is a(n) . a. umbilical hernia b. direct inguinal hernia c. Spigelian hernia d. femoral hernia ANS: D A femoral hernia is a hernia arising from a weakness in the transverse fascia below the inguinal ligament.

DIF:

2

REF: p. 503

19. An abdominal wall defect occurring in the linea alba at the umbilical ring is a(n) . a. umbilical hernia b. direct inguinal hernia c. Spigelian hernia d. femoral hernia ANS: A An umbilical hernia is an abdominal wall defect occurring in the linea alba at the umbilical ring. This hernia is most common in children and usually disappears spontaneously by age 2. In adults, the hernia appears more frequently in individuals with a high BMI. DIF:

2

REF: p. 503

20. A rare hernia occurring between the transverse abdominis and rectus muscles is a(n) . a. umbilical hernia b. direct inguinal hernia c. Spigelian hernia d. femoral hernia ANS: C A Spigelian hernia is a rare hernia occurring between the transverse abdominis and rectus muscles.

DIF:

2

REF: p. 503

21. The spermatic cord is retracted with a small a. red robinson b. JP drain

SOURCE: Browsegrades.net

.

c. ortho drain d. Penrose drain ANS: D The spermatic cord is retracted with a small Penrose drain.

DIF:

2

REF: p. 505

22. All of the following are supplies needed for a GI surgery, EXCEPT a. bowel bag b. vessel loops c. raney clips d. ultrasound scalpel

.

ANS: C All of the following are supplies needed for a GI surgery: HF vessel sealing system, ultrasound scalpel, vessel loops, ultrasound probe, bowel bag, and temporary ostomy bag.

DIF:

2

REF: p. 511

23. To place one or more clamps at a right angle to a tube or vessel is a. to cross-clamp b. to double-clamp c. resection d. anastomosis

.

ANS: A IoNreGcTlaBm.pC To cross-clamp is to place N onU eR orSm s aOt M a right angle to a tube or vessel.

DIF:

2

REF: p. 512

24. To place two clamps over a section of tissue to prevent bleeding when the tissue is severed is . a. to cross-clamp b. to double-clamp c. resection d. anastomosis ANS: B To double-clamp is to place two clamps over a section of tissue to prevent bleeding when the tissue is severed.

DIF:

2

REF: p. 512

25. A procedure in which a section of an organ is cut apart or removed is a. to cross-clamp b. anastomosis c. to double-clamp d. resection ANS: D

SOURCE: Browsegrades.net

.

Resection is a procedure in which a section of an organ is cut apart or removed.

DIF:

2

REF: p. 512

26. A procedure in which two hollow organs are joined surgically is a. to cross-clamp b. anastomosis c. to double-clamp d. resection

.

ANS: B Anastomosis is a procedure in which two hollow organs are joined surgically.

DIF:

2

REF: p. 512

27. The freeing up of tissue from its attachments before anastomosis or resection is . a. division b. mobilization c. to cross-clamp d. to clamp and divide ANS: B Mobilization is the freeing up of tissue from its attachments before anastomosis or resection.

DIF:

2

REF: p. 512

N R I G B.C M

28. A procedure in which one seU ctioS n ofNtissT ue is cuO t away from another is a. division b. mobilization c. cross-clamp d. clamp and divide

.

ANS: A Division is a procedure in which one section of tissue is cut away from another.

DIF:

2

REF: p. 512

29. Approximately 400,000 people die annually as a result of a. SSI b. wrong surgical site c. HAI d. obesity

.

ANS: D Approximately 400,000 people die annually as a result of obesity.

DIF:

2

REF: p. 521

30. This occurs most often as a postoperative complication or a result of pelvic or back injury and peritonitis .

SOURCE: Browsegrades.net

a. b. c. d.

paralytic ileus volvulus strangulation intussusception

ANS: A Paralytic ileus occurs most often as a postoperative complication or a result of pelvic or back injury and peritonitis.

DIF:

2

REF: p. 525

31. Telescoping of the intestines, occurring mainly in children and resulting in ischemia and necrosis of the bowel is . a. paralytic ileus b. volvulus c. strangulation d. intussusception ANS: D Intussusception is telescoping of the intestines, occurring mainly in children and resulting in ischemia and necrosis of the bowel.

DIF:

2

REF: p. 525

32. Twisting of the bowel on itself is a. paralytic ileus b. volvulus c. strangulation d. intussusception

.

ANS: B Volvulus is twisting of the bowel on itself.

DIF:

2

REF: p. 525

33. What type of stitch will be placed around the base of the appendix? a. Interrupted b. Horizontal c. Purse string d. None of the above ANS: C A purse-string stitch will be placed around the base of the appendix.

DIF:

2

REF: p. 532

34. During a laparoscopic cholecystectomy, which two structures are occluded? a. Cystic duct and common bile duct b. Common bile duct and artery c. Cystic duct and cystic artery d. Cystic artery and common bile duct

SOURCE: Browsegrades.net

ANS: C During a laparoscopic cholecystectomy, the cystic duct and cystic artery are occluded.

DIF:

2

REF: p. 537

35. During a splenectomy, what four major requirements must be met to stop bleeding? a. Access, visualization, good lighting, retractors b. Access, visualization, temperature, clamps c. Access, visualization, time, clamps d. Access, visualization, good lighting, clamps ANS: D During a splenectomy, four major requirements must be met to stop bleeding: access, visualization, good lighting, and clamps.

DIF:

2

REF: p. 541

36. A range of procedures are available for surgical management of a breast tumor. All of the following are available, EXCEPT . a. needle aspiration biopsy b. fine-needle insertion c. sentinel node detection d. lumpectomy ANS: D A range of procedures are available for surgical management of a breast tumor: needle aspiration biopsy, fine-needNleUiR nsSeI rtiN onG, T anBd.seCnO tinMel node detection.

DIF:

2

REF: p. 547

37. During this procedure, a gamma ray detecting probe is used to determine which lymph nodes are affected. a. excisional biopsy b. wire localization c. sentinel lymph node biopsy d. none of the above ANS: C During a sentinel lymph node biopsy, a gamma ray detecting probe is used to determine which lymph nodes are affected.

DIF:

2

REF: p. 548

SOURCE: Browsegrades.net

Chapter 24: Gynecological and Obstetrical Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The cervix is the lower neck of the a. bladder b. pelvic c. uterus d. canal

.

ANS: C The cervix is the lower neck of the uterus.

DIF:

2

REF: p. 556

2. The removal or destruction of tissue is called a. supination b. tracheation c. lacrimation d. ablation

.

ANS: D To remove or destroy tissue is to ablate.

DIF:

2

3.

G B.C M U S N T O

REFN : pR . 56I 6

is a fibrous, benign tumor of the uterus that usually arises from the myometrium. a. Leiomyoma b. Trocar c. Expulsion d. Insufflation ANS: A Leiomyoma is a fibrous, benign tumor of the uterus that usually arises from the myometrium.

DIF:

2

REF: p. 555

4. The anatomical area between the posterior vestibule and the anus is the a. fibrous b. oophorectomy c. perineum d. salpingectomy ANS: C The anatomical area between the posterior vestibule and the anus is the perineum.

DIF:

2

REF: p. 559

SOURCE: Browsegrades.net

.

5. Excessive bleeding during menses is a. conception b. fimbriae c. menorrhagia d. expulsion

.

ANS: C Excessive bleeding during menses is menorrhagia.

DIF: 6.

2

REF: p. 559

focuses on the treatment and prevention of diseases affecting the female reproductive system. a. Physiology b. Obstetrics c. Gynecology d. Surgery ANS: C Gynecology focuses on the treatment and prevention of diseases affecting the female reproductive system.

DIF:

7. a. b. c. d.

2

REF: p. 556

relates to the process of pregnancy and birth (parturition).

Endometrium Specialty Fetal Obstetrics

ANS: D Obstetrics relates to the process of pregnancy and birth (parturition).

DIF:

2

REF: p. 556

8. The is/are small projection(s) that extend from the end of the tube. a. placenta b. amniotic c. fimbriae d. eclampsia ANS: C The fimbriae are small projections that extend from the end of the tube.

DIF:

2

REF: p. 556

9. The structures that together make up the external genitalia are called the a. vulva b. cervix c. ova

SOURCE: Browsegrades.net

.

d. eclampsia ANS: A The structures that together make up the external genitalia are called the vulva.

DIF:

2

REF: p. 558

10. The is a raised mound of tissue that protects the symphysis pubis. a. sterile water b. electrolytic media c. vestibule d. mons pubis ANS: D The mons pubis is a raised mound of tissue that protects the symphysis pubis.

DIF:

2

REF: p. 558

11. The is a highly vascular organ that contains sensitive erectile tissue. a. pelvic b. incision c. clitoris d. pregnancy ANS: C The clitoris is a highly vascular organ that contains sensitive erectile tissue.

DIF:

2

.5 REFN : UpR S5I8NGTB.COM

12. The glands lie on both sides of the vestibule and secrete mucus during sexual intercourse. a. salpingectomy b. tubal c. Bartholin d. oophoroplasty ANS: C The Bartholin glands lie on both sides of the vestibule and secrete mucus during sexual intercourse.

DIF:

2

13. The term minora. a. myometrium b. endometrium c. vestibule d. fimbria

REF: p. 558 refers collectively to all the structures located within the labia

ANS: C The term vestibule refers collectively to all the structures located within the labia minora.

SOURCE: Browsegrades.net

DIF:

2

14. Most position. a. follicular b. gynecological c. luteal d. menstruation

REF: p. 558 procedures are performed with the patient in the supine or lithotomy

ANS: B Most gynecological procedures are performed with the patient in the supine or lithotomy position.

DIF:

2

15.

REF: p. 560 instruments are specialized for reproductive structures.

a. b. c. d.

Lateral Laparoscopic Supine Lithotomy

ANS: B Laparoscopic instruments are specialized for reproductive structures.

DIF: 16.

2

REF: p. 561

N R I G B.C M

pelvic proceU durS es reNquiT re vaginOal speculums and long instruments, including uterine clamps and heavy dissecting scissors. a. Cystocele b. Transvaginal c. Dermoid d. Rectocele ANS: B Transvaginal pelvic procedures require vaginal speculums and long instruments, including uterine clamps and heavy dissecting scissors.

DIF:

2

REF: p. 561

17. Surgical blockage prevents implantation (pregnancy) and development of a a. fetus b. uterine cyst c. uterine fibroid d. uterine tumor ANS: A Surgical blockage prevents implantation (pregnancy) and development of a fetus.

DIF:

2

REF: p. 573

SOURCE: Browsegrades.net

.

18. Continuous irrigation may be used to locate microscopic a. hernias b. bleeders c. veins d. arteries

.

ANS: B Continuous irrigation may be used to locate microscopic bleeders.

DIF:

2

REF: p. 576

19. LAVH is the removal of the uterus by a combined a. peritoneal b. laparoscopic c. periscopic d. microscopic

and vaginal approach.

ANS: B LAVH is the removal of the uterus by a combined laparoscopic and vaginal approach.

DIF:

2

20.

REF: p. 577 includes removal of the uterus and cervix.

a. b. c. d.

LSH TAH TUH FSU

ANS: B TAH includes removal of the uterus and cervix.

DIF:

2

REF: p. 578

21. In total abdominal hysterectomy, the surgeon uses separate the bladder and the uterus. a. Metzenbaum b. Masterson c. Mayo d. Heaney

scissors and long tissue forceps to

ANS: A Using Metzenbaum scissors and long tissue forceps, the surgeon separates the two structures by dissecting the peritoneal covering away from the bladder.

DIF: 22. A a. b. c. d.

2

REF: p. 579 hysterectomy is performed to treat pelvic malignancy.

radical primary partial tubal

SOURCE: Browsegrades.net

ANS: A A radical hysterectomy is performed to treat pelvic malignancy.

DIF:

2

23. During uterus. a. distention b. hysteroscopy c. D&C d. cystoscopy

REF: p. 582 a fiberoptic hysteroscope is inserted through the cervix and into the

ANS: B During hysteroscopy a fiberoptic hysteroscope is inserted through the cervix and into the uterus.

DIF: 24.

2

REF: p. 565

is absorption of fluid into the vascular system, leading to increased blood pressure and possible death related to fluid overload. a. Extravasation b. Micturition c. Insufflation d. Effusion ANS: A Extravasation is absorptionNoU fR fluSidIiN ntG oT thB e. vaCsO cuM lar system, leading to increased blood pressure and possible death related to fluid overload.

DIF:

2

REF: p. 555

25. The hysteroscope is inserted into the uterus with the a. medium b. monitor c. sheath d. laser

in place.

ANS: C The hysteroscope is inserted into the uterus with the sheath in place.

DIF:

2

REF: p. 565

26. The is constructed with an outer sheath that allows fluid outflow and an inner sheath for continuous irrigation. a. electrode b. resectoscope c. endometrial scope d. retriever ANS: B

SOURCE: Browsegrades.net

The resectoscope is constructed with an outer sheath that allows fluid outflow and an inner sheath for continuous irrigation.

DIF:

2

REF: p. 566

27. A(n) is a benign, smooth muscle tumor of the uterus. a. ablation b. leiomyoma c. amenorrhea d. impinge ANS: B A leiomyoma is a benign, smooth muscle tumor of the uterus.

DIF: 28. a. b. c. d.

2

REF: p. 567

is a nearly sterile fecal waste that accumulates while the fetus is in the uterus.

Meconium Muscle Cervical mucus Vernix

ANS: A Meconium is a nearly sterile fecal waste that accumulates while the fetus is in the uterus.

DIF:

2

REF: p. 556

N R I G B.C M

29. The is a thick orgaU n thS at aN dheT res to thOe uterus on the maternal side. a. embryo b. placenta c. gland d. fallopian tube ANS: B The placenta is a thick organ that adheres to the uterus on the maternal side.

DIF:

2

REF: p. 585

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Abdominal procedure b. Transcervical procedure c. Vaginal procedure 1.

2.

3.

4.

Repair of vesicovaginal fistula Removal of cystic Bartholin gland Hysteroscopy Tubal ligation

SOURCE: Browsegrades.net

5.

6.

7.

8.

TAH Resectoscope myomectomy Repair of cystocele LEEP

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS:

C C B A A B C B

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF:

p. 570 p. 571 p. 568 p. 573 p. 579 p. 567 p. 569 p. 560

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Placental abruption b. Placenta previa c. Nuchal cord d. Cord prolapsed 9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

An umbilical cord wrapped one or more times around the baby’s neck When the cord precedes the fetal head Seldom diagnosed before labor When the placenta implants completely or partially over the cervical os Usually identified on routinNeUuR ltrS asIoN unG dT inBt. heCpO reMnatal period Premature separation of the placenta from the uterine wall Usually occurs with an active baby in the early months of pregnancy Fetal demise results if the entire placenta separates from the uterus This condition more likely with breech presentation Can be caused by abdominal trauma, abnormalities of the uterus, a short umbilical cord, and hypertension

9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS: 18. ANS:

C D C B B A C A D A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 586 p. 588 p. 587 p. 585 p. 585 p. 585 p. 586-587 p. 585 p. 588 p. 585

SOURCE: Browsegrades.net

Chapter 25: Genitourinary Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Stones caused by the precipitation of minerals, such as calcium, and other substances from the urine or kidney filtrate are . a. uterine b. dilators c. calculi d. phila ANS: C Stones caused by the precipitation of minerals, such as calcium, and other substances from the urine or kidney filtrate are calculi.

DIF:

2

REF: p. 596

2. A urethral or ureteral catheter that is left in place is a(n) a. inguinal b. indwelling c. reverse d. permanent

catheter.

ANS: B A urethral or ureteral catheN ter tR hat I is leGft inBp.laCce M is an indwelling catheter.

U S N T

DIF:

2

O

REF: p. 606

3. Backward (opposite of its normal direction) flow of a body fluid is a. reflux b. epispadias c. undescended d. hydrocele

.

ANS: A Backward (opposite of its normal direction) flow of a body fluid is reflux.

DIF: 4.

2

REF: p. 621

is an instrument or other device that puts pressure on tissue, usually to stop bleeding. a. McBurney b. Transurethral c. Epigastric d. Tamponade ANS: D Tamponade is an instrument or other device that puts pressure on tissue, usually to stop bleeding.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 606

5. Twisting of an organ or a structure on itself is a. fiberoptic b. torsion c. residual d. hemorrhage

.

ANS: B Twisting of an organ or a structure on itself is torsion.

DIF:

2

REF: p. 596

6. The cavity lies posterior to (behind) the peritoneal cavity. a. retroperitoneal b. electrolytic c. abdominal d. thoracic ANS: A The retroperitoneal cavity (also referred to as the retroperitoneal space) lies posterior to (behind) the peritoneal cavity.

DIF:

2

REF: p. 597

7. The are the primN ary R orgI ans G for B fil. trC atioM n of the blood.

U S N T O a. kidneys b. fascia c. prostatectomy d. cortex ANS: A The kidneys are the primary organs for filtration of the blood.

DIF:

2

REF: p. 597

8. The is composed of a vast system of microscopic tubules that communicate directly with the capillaries to filter the blood. a. glomerulus b. absorption c. ultrasound d. osmolality ANS: A The glomerulus is composed of a vast system of microscopic tubules that communicate directly with the capillaries to filter the blood.

DIF:

2

REF: p. 597

SOURCE: Browsegrades.net

9.

stones (calculi) are formed by the precipitation of specific salts from filtrate that becomes supersaturated. a. Kidney b. Supine c. Lateral d. Crystalline ANS: A Kidney stones (calculi) are formed by the precipitation of specific salts from filtrate that becomes supersaturated.

DIF:

2

REF: p. 603

10. The glands are paired organs that lie on the medial side of the upper kidney. a. phrenic b. adrenal c. segmental d. muscular ANS: B The adrenal glands are paired organs that lie on the medial side of the upper kidney.

DIF:

2

REF: p. 599

11. The communicates with the lower bladder to enable excretion of urine from the body. a. bladder b. secreting c. urethra d. cancerous ANS: C The urethra communicates with the lower bladder to enable excretion of urine from the body.

DIF:

2

12. The a. pelvis b. sperm c. scrotum d. tunica

REF: p. 600 is a layered tissue sac that encases the testicles.

ANS: C The scrotum is a layered tissue sac that encases the testicles.

DIF:

2

REF: p. 600

13. The gland surrounds the urethra and secretes an alkaline fluid that contributes to seminal fluid. a. Cowper

SOURCE: Browsegrades.net

b. lactated c. prostate d. sterile ANS: C The prostate gland surrounds the urethra and secretes an alkaline fluid that contributes to seminal fluid.

DIF: 14.

2

REF: p. 601

patients are extremely careful of their AV access sites and need to take precautions to prevent injury at the site. a. Adrenalectomy b. Nephrectomy c. Prostatectomy d. Hemodialysis ANS: D Hemodialysis patients are extremely careful of their AV access sites and need to take precautions to prevent injury at the site.

DIF:

2

REF: p. 599

15. A(n) may be used to outline structures of the urinary system, including any stones larger than 2 mm. a. KUB b. epididymis c. necrosis d. mass ANS: A A KUB may be used to outline structures of the urinary system, including any stones larger than 2 mm.

DIF: 16. A a. b. c. d.

2

REF: p. 602 attaches to the head of the scope and accepts accessory tools.

bridge gap filter bladder

ANS: A A bridge attaches to the head of the scope and accepts accessory tools.

DIF: 17.

2

REF: p. 605

uses a rigid or flexible scope, which is inserted through the urethra and advanced into the renal pelvis and ureter. a. Cystoscopy b. Ureteroscopy

SOURCE: Browsegrades.net

c. Colporrhaphy d. Arthodesis ANS: B Ureteroscopy uses a rigid or flexible ureteroscope, which is inserted through the urethra and advanced into the renal pelvis and ureter.

DIF:

2

REF: p. 606

18. Whenever electrosurgical instruments are used, the irrigation fluid must be a. electrolytic b. nonelectrolytic c. chilled d. warmed

.

ANS: B Whenever electrosurgical instruments are used, the irrigation fluid must be nonelectrolytic.

DIF:

2

REF: p. 603

19. In adult circumcision, a _ a. dorsal b. dextran c. ventral d. lateral

incision is made in the skin and carried circumferentially.

ANS: A A dorsal incision is made inNtU hR e sSkI inNaG ndTcB ar. riC edOcM ircumferentially.

DIF: 20. A a. b. c. d.

2

REF: p. 627

is a benign, fluid-filled sac that develops in the anterior testis varicocele hydrocele spermatocele chordee

ANS: B A hydrocele is a benign, fluid-filled sac that develops in the anterior testis.

DIF:

1

21. Patients are a. monitored b. surveyed c. queried d. prepped

REF: p. 629 for postoperative swelling and possible hemorrhage.

ANS: A Patients are monitored for postoperative swelling and possible hemorrhage.

SOURCE: Browsegrades.net

DIF:

1

REF: p. 621

22. A(n) prosthesis is placed into the scrotal sac after orchiectomy a. penile b. epididymal c. testicular d. prostatic ANS: A A testicular prosthesis is placed into the scrotal sac after orchiectomy.

DIF:

1

REF: p. 632

23. In robotic-assisted prostatectomy, the patient is prepped and draped for an abdominal laparoscopic procedure in the position. a. prone b. lithotomy c. supine d. jack-knife ANS: B The patient is prepped and draped for an abdominal laparoscopic procedure in the lithotomy position.

DIF:

1

REF: p. 624

24. Kidney transplantation is pN erfoR rmeI d foGr acBu. teC andMchronic U S N T O a. ESRD b. QAQC c. KBU d. PKU

.

ANS: A Kidney transplantation is performed for acute and chronic ESRD. DIF:

1

REF: p. 620

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Kidney b. Ureter c. Urethra d. Bladder 1.

2.

3.

4.

Anastomosed to the ilium when creating an ileal conduit Renal calculus Contains a region called the trigone Meatotomy

SOURCE: Browsegrades.net

5.

6.

7.

8.

Communicates with the lower bladder for excretion of urine from the body Distended with fluid to enhance visualization during cystoscopic procedures Moves urine along by peristalsis Composed of four tissue layers: the outer serosa, the muscular layer, the submucosa, and the inner mucosa 9. Have two main tissue layers, an outer cortex and the inner medulla 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS:

B A D C C D B D A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 612 p. 603 p. 600 p. 596 p. 600 p. 603 p. 599 p. 600 p. 597

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Open procedure b. Transurethral procedure c. Percutaneous procedure 10.

11.

12.

13.

14.

15.

16.

Cystoscopy TURP Kidney transplant Ureteral stent placement Uses continuous irrigation Insertion of penile implant Suprapubic prostatectomy

10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS:

B B A B B A A

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF:

p. 602 p. 621 p. 620 p. 608 p. 621 p. 629 p. 622

SOURCE: Browsegrades.net

Chapter 26: Ophthalmic Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1.

is a procedure performed to treat glaucoma. a. b. c. d.

Keratoplasty Iridectomy Vitrectomy Trabeculectomy

ANS: D A trabeculectomy is performed to create a channel from which the aqueous humor may drain from the anterior chamber. This procedure is performed for the treatment of glaucoma.

DIF:

2

REF: p. 656

2. Surgical removal of the eyeball after the eye muscles and optic nerve have been severed is called . a. enucleation b. evisceration c. exenteration d. keratoplasty ANS: A Enucleation is complete removal the NURSofIN Geyeball B.CO(globe).

M Evisceration is a similar procedure T in which the contents of the eye are removed, but the outer shell of the sclera and the muscle attachments are left intact.

DIF:

2

REF: p. 658

3. A condition in which the crystalline lens of the eye or its capsule, or both, becomes opaque, with consequent loss of vision, is known as . a. capsulorrhexis b. a cataract c. glaucoma d. enucleation ANS: B Clouding of the eye, caused by a disease in which the crystalline lens of the eye, or its capsule, or both, become opaque. This prevents light from focusing on the retina, resulting in visual distortion. Cataracts may develop as a result of disease or injury.

DIF: 4.

2

REF: p. 634

is performed to create a permanent opening in the tear duct for the drainage of tears. a. Lacrimal duct probing b. Dacryocystorhinostomy

SOURCE: Browsegrades.net

c. Dacryocystitis d. Dacryocystocele ANS: B Dacryocystorhinostomy is the creation of a permanent opening in the tear duct for the drainage of tears.

DIF:

2

REF: p. 646

5. Ophthalmic muscle surgery is performed to correct deviation of the eye caused by . a. blunt trauma b. paralysis of the levator palpebrae muscle c. deficient nerve stimulation d. strabismus ANS: D Muscle resection and muscle recession are performed to correct deviation of the eye caused by strabismus. In this procedure, the affected muscles are removed and reattached to the proper location.

DIF:

2

REF: p. 647

6. Ectropion is the abnormal inversion of the a. eyelashes b. bilateral upper eyelids c. upper eyelid d. lower eyelid

.

ANS: D Ectropion is drooping of the lower eyelid. This creates an overflow of tears and exposes the conjunctiva, which becomes dry and irritated.

DIF: 7.

2

REF: p. 659

is performed to treat an intraocular malignancy such as retinoblastoma and melanoma. a. Exenteration b. Blepharoplasty c. Enucleation d. Evisceration ANS: C Enucleation is performed to treat intraocular malignancy (e.g., retinoblastoma and melanoma), a penetrating ocular wound, a painful blind eye, or an eye that is blind and painless but disfigured.

DIF:

2

REF: p. 658

8. A common technique to repair a retinal detachment is to produce detached layers.

SOURCE: Browsegrades.net

between the

a. b. c. d.

vitreous adhesions blood supply nervous intervention

ANS: B A common technique is to produce adhesions between the layers using cryotherapy (freezing of the tissue) or diathermy (mild heat created by a diathermy unit or laser).

DIF:

2

9.

REF: p. 654 is/are made of lint-free cellulose or similar material.

a. b. c. d.

Sutures Eye sponges Implants Gauze

ANS: B Eye sponges are made of lint-free cellulose or similar material.

DIF:

2

REF: p. 644

10. Which of the following statements regarding ophthalmic sutures is true? a. Sutures are available in sizes 0 to 6–0. b. Single-armed sutures are used. c. Sutures should be handled as little as possible. d. Double-armed sutures aNre uRsedIto cGlosB e. puC ncture M wounds.

U S N T

O

ANS: C Sutures should be handled as little as possible, and the points of the needles should be protected from damage.

DIF:

2

REF: p. 644

11. A process in which the lens continually changes shape to maintain the focus of an image on the retina is . a. anatomy b. ophthalmic c. accommodation d. traction ANS: C A process in which the lens continually changes shape to maintain the focus of an image on the retina is accommodation.

DIF:

2

REF: p. 634

12. Clear, watery fluid that fills the anterior and posterior chambers in the front of the eye is called . a. vitreous humor b. choroid

SOURCE: Browsegrades.net

c. aqueous humor d. enucleation ANS: C A clear fluid produced by the ciliary epithelium, called aqueous humor, fills the anterior and posterior chambers.

DIF:

2

REF: p. 637

13. An operation performed when the sensory layer of the retina and the pigment epithelium layer become separated from each other is called . a. scleral buckling b. cataract extraction c. vitreous replacement d. keratoplasty ANS: A Scleral buckling surgery is performed when the sensory layer of the retina becomes separated from the pigment epithelial layer.

DIF:

2

REF: p. 654

14. The tissue that refracts light rays as they enter the eye is called the a. retina b. crystalline lens c. iris d. cornea

.

ANS: D The light rays are refracted as they pass through the cornea, aqueous humor, lens, and vitreous, and the rays converge at the focal point.

DIF:

2

REF: p. 635

15. A pigmented contractile membrane composed mainly of muscle tissue is known as the . a. pupil b. palpebral conjunctiva c. lacrimal caruncle d. iris ANS: D The iris is a pigmented membrane composed mainly of muscle tissue that surrounds the pupil.

DIF:

2

REF: p. 636

16. Surgery in which the eye muscle is moved back to release the globe is muscle a. aqueous b. choroid c. recession

SOURCE: Browsegrades.net

.

d. ciliary ANS: C Surgery in which the eye muscle is moved back to release the globe is muscle recession.

DIF:

2

REF: p. 648

17. The anterior space in front the lens and iris is called the a. anterior chamber b. posterior chamber c. posterior cavity d. anterior cavity

.

ANS: A The anterior chamber lies in front of the iris, whereas the posterior chamber lies behind the iris but in front of (anterior to) the lens.

DIF: 18.

2

REF: p. 637

is the inability to coordinate the extraocular muscles, which prevents binocular vision. a. Strabismus b. Ophthalmic c. Keratoconus d. Conjunctivitis ANS: A Strabismus is the inability tN oU coRoS rdI inN atG eT thB e. exCtrO aoMcular muscles, which prevents binocular vision.

DIF:

19. a. b. c. d.

2

REF: p. 634

is an abnormal inversion of the lower eyelid.

Entropion Nausea Evisceration Blepharoptosis

ANS: A Entropion is an abnormal inversion of the lower eyelid.

DIF:

2

REF: p. 659

20. When the surgeon is required to look away from the field, he or she a. is able to take questions and discuss the next step b. loses concentration and the rhythm of the surgery c. is refocusing in order to carry on d. is allowing the eyes and mind a short break ANS: B

SOURCE: Browsegrades.net

.

When required to look away from the field, the surgeon loses concentration and the rhythm of the surgery.

DIF:

2

REF: p. 644

21. A(n) is an outwardly turned eyelid. a. ectropion b. ptosis c. canthus d. presbyopia ANS: A An ectropion is an outwardly turned eyelid.

DIF:

2

REF: p. 659

22. Following a cataract extraction, a(n) considered a complication of the surgery. a. anterior b. posterior c. ventral d. dorsal

vitrectomy may be indicated, which is

ANS: A Many surgeons groove the nucleus of the cataract and separate it into four quadrants before proceeding. This is a complication of the surgery and may necessitate an anterior vitrectomy.

DIF:

2

REF: p. 653-654

23. An intravitreous gas injection is done to create pressure on the retina. The gases used include . a. sulfur hexafluoride and perfluoropropane b. carbon dioxide and ethylene oxide c. glutaraldehyde d. nitrous oxide ANS: A The gas infusion exerts pressure on the retina while subretinal fluid is reabsorbed and scarification takes place. The gases include sulfur hexafluoride (SF6) and perfluoropropane (C3F8).

DIF:

2

REF: p. 655

24. Glaucoma is classified as primary or secondary. a. anterior chamber or posterior chamber b. open angle or closed angle c. OD or OS d. right angle or left angle

SOURCE: Browsegrades.net

and then further classified as

ANS: B Glaucoma is classified as open angle or closed angle and then further categorized as primary or secondary.

DIF:

2

REF: p. 656

25. Fluorescein angiography is used extensively in the diagnosis and evaluation of disease. a. retinal and choroid b. corneal and Graves c. keratoconus d. right and left angle glaucoma ANS: A Fluorescein angiography is used extensively in the diagnosis and evaluation of retinal and choroid diseases.

DIF:

2

26. The eyeball. a. sclera b. cornea c. pupil d. iris

REF: p. 639 is a thick, white, fibrous tissue that encloses about three fourths of the

ANS: A The sclera is a thick, white, fibrous tissue that encloses about three fourths of the eyeball.

DIF:

2

REF: p. 635

27. The lens lies directly behind the iris in the a. projected b. dorsal c. posterior d. anterior

chamber.

ANS: D The lens lies directly behind the iris in the anterior chamber.

DIF:

2

28.

REF: p. 637 is the bending of light rays through a transparent medium.

a. b. c. d.

Irritation Infraction Refraction Reflection

ANS: C Refraction is the bending of light rays through a transparent medium.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 638

29. The eyelid margins are cleaned using cotton-tip a. applicators b. sponges c. Q-tips d. 4  4s

.

ANS: A The eyelid margins are cleaned using cotton-tip applicators.

DIF:

2

REF: p. 640

30. Most ophthalmic surgery is performed using a regional anesthetic with monitored . a. sleeping b. position c. sedation d. breathing ANS: C Most ophthalmic surgery is performed using a regional anesthetic with monitored sedation.

DIF:

2

REF: p. 640

31. Eye sponges are made of lint-free a. absorption b. latex c. rubber d. cellulose

or similar material.

ANS: D Eye sponges are made of lint-free cellulose or similar material.

DIF:

2

REF: p. 644

32. A soft dressing or hard a. shield b. scope c. patch d. sponge

may be used to protect the eye after surgery.

ANS: A A soft dressing or hard shield may be used to protect the eye after surgery.

DIF:

2

33.

REF: p. 644 requires dexterity and a steady hand.

a. Positioning b. Microsurgery c. X-raying

SOURCE: Browsegrades.net

d. Scrubbing ANS: B Microsurgery requires dexterity and a steady hand.

DIF:

2

REF: p. 645

34. A is an inflammatory, benign growth that originates in a sebaceous gland of the eyelid. a. chalazion b. cyst c. pterygium d. strabismus ANS: A A chalazion is an inflammatory, benign growth that originates in a sebaceous gland of the eyelid.

DIF:

2

REF: p. 645

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Enucleation b. Evisceration 1.

2.

3.

4.

5.

6.

7.

N R I G B.C M

O Complete removal of the eyeU ballS N T Leaves the outer shell of the sclera with its muscle attachments intact Surgical removal of the eyeball after the eye muscles and optic nerve have been severed Removal of the entire contents of the orbit An implant is inserted to shape the orbital cavity The removal of the contents of the eye Performed to treat intraocular malignancy, such as retinoblastoma and melanoma

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS:

A B A B A B A

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF:

p. 658 p. 658 p. 658 p. 634 p. 658 p. 658 p. 658

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Anterior chamber b. Soft tissue c. Posterior cavity

SOURCE: Browsegrades.net

8.

9.

10.

11.

12.

13.

14.

15.

Repair of entropion Performed using a phacoemulsifier Dacryocystorhinostomy Scleral buckling Performed when the sensory layer of the retina becomes separated Cataract Vitreous humor Aqueous humor

8. ANS: 9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS:

B A B C C A C A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF:

p. 659 p. 652 p. 647 p. 648 p. 649 p. 652 p. 653 p. 637

SOURCE: Browsegrades.net

Chapter 27: Surgery of the Ear, Nose, Pharynx, and Larynx Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Which of the following instruments would be used to remove nasal polyps? a. Wilde forceps b. Crowe-Davis c. Bayonette forceps d. Jansen forceps ANS: A Under direct visualization with the nasal endoscope, the surgeon uses either a Wilde forceps or micro debrider to remove the nasal polyps.

DIF:

2

REF: p. 685

2. At what age is a cochlear implant contraindicated in children? a. Under 2 years old b. Under 3 years old c. More than 5 years old d. Not contraindicated in children, regardless of their age ANS: A Congenital deafness in the child can be treated with a cochlear implant, but surgery is delayed until age 2.

DIF:

2

3. Earwax is known as a. cerumen b. keratin c. cholesteatoma d. epistaxis

REF: p. 679 .

ANS: A The lateral one third of the external auditory canal is surrounded with cartilage and is lined with glands that secrete a waxy substance called cerumen.

DIF:

2

REF: p. 662

4. The transmits the vibrations of the tympanic membrane (TM) and the other ossicles to the inner ear via the oval window. a. stapes b. malleus c. incus d. anvil ANS: A

SOURCE: Browsegrades.net

The stapes (stirrup) transmits the vibrations of the TM and the other ossicles to the inner ear via the oval window.

DIF:

2

REF: p. 663

5. Reconstruction of the and oropharynx, or uvulopalatopharyngoplasty, is performed to reduce and tighten oropharyngeal tissue. a. eyelid b. polyps c. uvula d. ear ANS: C Reconstruction of the uvula and oropharynx, or uvulopalatopharyngoplasty, is performed to reduce and tighten oropharyngeal tissue.

DIF: 6. A a. b. c. d.

2

REF: p. 688

suction device is used to remove the morcellated tissue. #9 Yankauer #10 Poole #12 Frazier #11 Taylor

ANS: C A #12 Frazier suction device is used to remove the morcellated tissue.

DIF:

2

N R I G B.COM

REF: Up. 6S85N T

7. The primary reasons for performing an adenoidectomy are obstruction caused by hypertrophy of the tissue. a. chronic b. mild c. high d. low

infection and

ANS: A The primary reasons for an adenoidectomy are chronic infection and obstruction caused by hypertrophy of the tissue.

DIF:

2

REF: p. 688

8. The neck is anatomically divided into triangles for a. division b. labeling c. classification d. identification

.

ANS: D The neck is anatomically organized into triangles for identification.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 693

9. During a tracheostomy, the a. obturator b. primary tube c. balloon syringe d. universal connector

is kept with the patient in his or her room.

ANS: A The obturator of the tracheostomy tube is kept with the patient as long as the tracheal tube is in place.

DIF:

2

REF: p. 692

10. Myringoplasty is performed to close a small, nonhealing hole in the a. RW b. TM c. OV d. ME

.

ANS: B A myringoplasty is performed to close a small, nonhealing hole in the TM. DIF:

2

11. The a. pharynx b. oropharynx c. nasopharynx d. hypopharynx

REF: p. 675 is situated behind the nasal cavity and above the oral cavity.

ANS: C The nasopharynx is situated behind the nasal cavity and above the oral cavity.

DIF:

2

REF: p. 680

12. Turbinectomy generally is performed at the same time as a. septoplasty b. deformities c. increases d. airflow ANS: A ] Turbinectomy generally is performed at the same time as septoplasty.

DIF:

2

REF: p. 686

13. The glands are situated within the lobes of the thyroid. a. parathyroid

SOURCE: Browsegrades.net

.

b. sphenoid c. paralysis d. magnesium ANS: A The parathyroid glands are situated within the lobes of the thyroid.

DIF:

2

14. The paired a. sphenoid b. maxillary c. frontal d. ethmoid

REF: p. 694 sinuses are the large sinuses below the ocular orbits.

ANS: B The paired maxillary sinuses are the large sinuses below the ocular orbits.

DIF:

2

REF: p. 680

15. An incision is made in the a. nasopharynx b. oropharynx c. hypopharynx d. nasal septum

below the obstruction with a #15 blade.

ANS: D GTbeBlo.wCtOheMobstruction with a #15 blade.

An incision is made in the N naU saR lS seI ptN um DIF:

2

REF: p. 687

16. Most endoscopic procedures of the nose are performed to treat a. cancerous neoplasms b. benign disease c. congenital polyps d. inflammatory or infectious diseases

.

ANS: D Most endoscopic procedures of the nose are done to treat inflammatory or infectious diseases.

DIF:

2

REF: p. 685

17. A cochlear implant is used to transmit external sound directly to the a. eighth cranial nerve b. semicircular canals c. tenth cranial nerve d. twelfth cranial nerve ANS: A

SOURCE: Browsegrades.net

.

A cochlear implant is used to transmit external sound directly to the eighth cranial nerve. It is used in the treatment of sensorineural deafness.

DIF:

2

REF: p. 678

18. Cholesteatoma, eustachian tube dysfunction, neoplasm, or congenital malformation of the middle ear may block airflow to the mastoid and cause chronic . a. mastoiditis b. labyrinthitis c. cholestasis d. otitis media ANS: A Cholesteatoma, eustachian tube dysfunction, neoplasm, or congenital malformation of the middle ear may block airflow to the mastoid and cause chronic mastoiditis.

DIF:

2

REF: p. 676

19. The medical abbreviation TM stands for a. temporomandibular joint disease b. tympanic membrane c. transcendental meditation d. transverse myelitis

.

ANS: B The medical abbreviation TM stands for tympanic membrane.

DIF:

2

N R I G B.COM

REF: Up. 6S63N T

20. The 30-degree scope is used for maxillary, sphenoid, and a. thyroid b. ethmoid c. lacrimal d. palatine

sinus procedures.

ANS: B The 30-degree scope is used for maxillary, sphenoid, and ethmoid sinus procedures.

DIF:

2

REF: p. 685

21. The submandibular duct, or Wharton duct, emerges from the deep anterior portion of the gland and drains into the floor of the mouth. a. anterior b. parotid and hypoglossal c. dorsal d. posterior ANS: A The submandibular duct, or Wharton duct, emerges from the deep anterior portion of the gland and drains into the anterior floor of the mouth.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 694

22. Thyroid hormones (THs) are necessary for regulating a. cell metabolism and growth b. digestion and temperature c. estrogen and progesterone d. gastrin and glucagon

.

ANS: A The thyroid hormones (THs) are necessary for regulating cell metabolism and growth.

DIF:

2

REF: p. 694

23. A is almost always combined with a total laryngectomy to treat laryngeal metastasis or problems with aspiration. a. glossectomy b. sialendoscopy c. turbinectomy d. tonsillectomy ANS: A A total glossectomy is almost always combined with a total laryngectomy to treat laryngeal metastasis or problems with aspiration.

DIF:

2

REF: p. 701

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Ear b. Neck c. Nose d. Oropharynx and larynx 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Anatomically divided into triangles Contains the ossicles Contains the adenoids Otitis media Formed by two U-shaped cartilaginous structures called the lower lateral cartilages Maxillary sinus is approached through this Uvulopalatopharyngoplasty (UPP) Contains the turbinates Contain the arytenoid cartilages Anatomy is divided into three regions

1. ANS: B 2. ANS: A 3. ANS: D

DIF: DIF: DIF:

3 3 3

REF: p. 693 REF: p. 663 REF: p. 681

SOURCE: Browsegrades.net

4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS:

A C C D C D A

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF:

p. 663 p. 680 p. 680 p. 688 p. 680 p. 681 p. 662

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. External ear b. Middle ear c. Internal ear 11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Crista ampullaris Proximal eustachian tube Intratympanic portion of the facial nerve Contains cerumen Auricle or pinna Responsible for equilibrium Examined with an otoscope Ossicular reconstruction Cochlear implant Stapedectomy

11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS: 18. ANS: 19. ANS: 20. ANS:

C B B A A C A B C B

DIF:NU3RSINGTB.RC EO F:M p. 663 DIF: 3 REF: p. 663 DIF: 3 REF: p. 663 DIF: 3 REF: p. 663 DIF: 3 REF: p. 663 DIF: 3 REF: p. 663 DIF: 3 REF: p. 665 DIF: 3 REF: p. 677 DIF: 3 REF: p. 663 DIF: 3 REF: p. 677

SOURCE: Browsegrades.net

Chapter 28: Oral and Maxillofacial Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Procedures involving the surgeon. a. eyes b. brain c. teeth d. maxillary sinuses

are performed primarily by an oral-maxillofacial

ANS: C Procedures involving the teeth are performed primarily by an oral-maxillofacial surgeon.

DIF:

2

REF: p. 705

2. The face is divided into which of the following three parts? a. Medial face, distal face, and proximal face b. Superior face, inferior face, and medial face c. Upper face, midface, and lower face d. Superior face, midface, and inferior face ANS: C The face is divided into three parts: upper face, midface, and lower face.

DIF:

2

3.

N R I G B.COM

REF: Up. 7S06N T

are implanted to realign dentition of the mandible and midface. a. b. c. d.

Dental implants Arch bars Miniplates Bone grafts

ANS: B Arch bars are implanted to realign dentition of the mandible and midface.

DIF:

2

REF: p. 711

4. Le Fort is a horizontal fracture of the maxilla that causes the hard palate and alveolar process to become separated from the remainder of the maxilla. The fracture extends into the lower nasal septum, lateral maxillary sinus, and palatine bones. a. II b. III c. IV d. I ANS: D

SOURCE: Browsegrades.net

Le Fort I is a horizontal fracture of the maxilla that causes the hard palate and alveolar process to become separated from the remainder of the maxilla. The fracture extends into the lower nasal septum, lateral maxillary sinus, and palatine bones.

DIF:

2

REF: p. 706

5. Complications of entrapment of the eye muscles. a. orbital floor fractures b. dental implants c. arch bar applications d. bone grafts

include extrusion of the globe into the nasal sinus and

ANS: A Complications of orbital floor fractures include extrusion of the globe into the nasal sinus and entrapment of the eye muscles.

DIF: 6.

2

REF: p. 709

focuses on reconstruction and repairs of the facial bones and may include structures of the oral cavity. a. Odontectomy surgery b. Oromaxillofacial surgery c. TMJ arthroplasty d. Dental implantation surgery ANS: B Oromaxillofacial surgery focuses on reconstruction and repairs of the facial bones and may include structures of the oral cavity.

DIF:

7.

2

REF: p. 705

dictate(s) that wires on arch bars be tightened in a clockwise fashion so that any other surgeon knows to remove them in a counter-clockwise direction. a. Operating room policy b. AORN c. Surgeon’s preference cards d. Standard protocol ANS: D Standard protocol dictates that wires be tightened in a clockwise fashion so that any other surgeon knows to remove them in a counter-clockwise direction.

DIF:

8.

2

REF: p. 712

are performed primarily by oral-maxillofacial, plastic, or otorhinolaryngology surgeons. a. Dental implants b. Maxillofacial procedures c. Odontectomies

SOURCE: Browsegrades.net

d. CT scans ANS: B Maxillofacial procedures are performed primarily by oral-maxillofacial, plastic, or otorhinolaryngology surgeons.

DIF:

2

REF: p. 705

9. In the Le Fort fracture, there is a separation of all the facial bones from their cranial base. It includes fracture of the zygoma, maxilla, and nasal bones. The fracture line extends through the ethmoid bone and bony orbit with severe facial flattening and swelling. a. II b. IV c. III d. I ANS: C In the Le Fort III fracture, there is a separation of all the facial bones from their cranial base.

It includes fracture of the zygoma, maxilla, and nasal bones. The fracture line extends through the ethmoid bone and bony orbit with severe facial flattening and swelling.

DIF: 10.

2

REF: p. 706

of injury or congenital anomalies can affect speech, mastication (chewing), and development of the teeth. a. Applying arch bars for the repair b. Using dental implants fN or tR he rI epaiG r B.C M U S N T O c. The repair d. Long-term physiological effects ANS: D Long-term physiological effects of injury or congenital anomalies can affect speech, mastication (chewing), and development of the teeth.

DIF:

2

REF: p. 705

11. The Le Fort fracture is pyramidal. It extends from the nasal bone, to the frontal processes of the maxilla, lacrimal bones, and inferior orbital floor, and may extend into the orbital foramen. Inferiorly, it extends into the anterior maxillary sinus, and into the pterygoid plates. a. II b. IV c. III d. I ANS: A The Le Fort II fracture is pyramidal. It extends from the nasal bone, to the frontal processes of the maxilla, lacrimal bones, and inferior orbital floor, and may extend into the orbital foramen. Inferiorly, it extends into the anterior maxillary sinus, and into the pterygoid plates. This fracture is also associated with leakage of cerebrospinal fluid into the nasal sinuses.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 706

12. The forms the bridge of the nose and articulates with the ethmoid and maxilla. a. zygoma b. nasal bone c. arch bar d. temporal bone ANS: B The nasal bone forms the bridge of the nose and articulates with the ethmoid and maxilla.

Fractures of the nasal ethmoid area may injure the lacrimal apparatus, including the ducts and lacrimal gland.

DIF:

2

13. The a. mandible b. zygomatic arch c. nasal bone d. maxilla

REF: p. 706 is the only movable bone of the face.

ANS: A The mandible is the only movable bone of the face. It is a U-shaped bone that is suspended from the temporal bone.

DIF: 14. a. b. c. d.

2

G B.C M U S N T O

REFN : pR . 70I 6

are the primary means of repairing facial fractures.

Plates and screws Dental implants and bone grafts Skin grafts and bone grafts Gingival grafts and bone grafts

ANS: A Plates and screws are the primary means of repairing facial fractures.

DIF:

2

REF: p. 706

15. Surgery involving the bones of the face, primarily for repair of fractures and reconstruction for congenital anomalies, is defined as . a. oral-maxillofacial surgery b. cranialization c. fascial fracture reconstruction d. cerebralization ANS: A Oral-maxillofacial surgery involves the bones of the face, primarily for repair of fractures and reconstruction for congenital anomalies.

DIF:

2

REF: p. 705

SOURCE: Browsegrades.net

16.

is the number, type, and pattern of the teeth. a. b. c. d.

Mastication Dentition Micturition Occlusion

ANS: B Dentition is the number, type, and pattern of the teeth.

DIF:

2

REF: p. 705

17. A screw that penetrates both cortical layers and the intervening spongy layer of the bone is called a screw. a. bicortical b. cannulated c. bicoronal d. subciliary ANS: A A bicortical screw penetrates both cortical layers and the intervening spongy layer of the bone.

DIF:

2

REF: p. 705

18. Also called application of arch bars, a procedure in which the maxilla and mandible are placed in their normally cloNsedRposIitioG n anBd.fiC xedMwith wires is called .

U S N T O a. maxillomandibular fixation (MMF) b. reconstructive surgery c. sternocleidomastoid surgery d. mandibular joint fixation ANS: A MMF, also called application of arch bars, is a procedure in which the maxilla and mandible are placed in their normally closed position (jaw closed) and fixed with wires.

DIF:

2

19. The a. zygoma b. ethmoid c. sphenoid d. maxilla

REF: p. 711 forms the lateral walls and floor of the bony orbit, which houses the eyeball.

ANS: A The zygoma forms the lateral walls and floor of the bony orbit, which houses the eyeball.

DIF:

2

REF: p. 706

MATCHING

SOURCE: Browsegrades.net

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Upper face b. Midface c. Lower face 1. Fractures in this area are important in their association with injury to the eye, especially in displaced fractures.

2. The mandible is the only movable bone of the face. It is a U-shaped bone that is suspended from the temporal bone.

3. The frontal bone is part of the cranium but forms the forehead and contains portions of the nasal sinuses.

4. The bony orbit is formed by the frontal bone, but also contains portions of other bones of the face. These include the zygoma, maxilla, lacrimal, ethmoid, sphenoid, and palatine bones.

5. The ramus extends inferiorly from the condyle to the angle, where it joins the body of the mandible and extends anteriorly and medially to join the other half of the mandible.

6. The ethmoid bone is a complex structure that contributes to the floor of the cranium and contains a number of sinus cavities.

7. The condyles insert into the glenoid fossa of the temporal bones to form the temporomandibular joints.

8. The bilateral maxillae come together to form the upper jaw, anterior hard palate, and a portion of the orbital cavities.

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS:

B C A B C B C B

DIF: 3 REF: p. 706 DIF:N 3R I G B.RCEF:M p. 706 DIF: U3 S N T REO F: p. 706 DIF: 3 REF: p. 706 DIF: 3 REF: p. 706 DIF: 3 REF: p. 706 DIF: 3 REF: p. 706 DIF: 3 REF: p. 706

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Maxillomandibular fixation (MMF) or arch bars b. Open reduction internal fixation 9. In this procedure, fractures are reduced and fixated. The buttressing structures are reinforced.

10. Implanted to realign dentition of the mandible and midface.

11. If kept in place postoperatively, wire cutters must be sent with the patient to the postanesthesia care unit so that the mouth can be opened in the event of an airway emergency.

12. The surgeon chooses the size and type of plate to be used.

13. The appropriate drill bit is loaded into a small power drill, and the screw holes are drilled.

14. If a drill guide is used, a depth gauge is used to measure the screw length required.

SOURCE: Browsegrades.net

15. A wire is clamped with a Rubio needle holder, threaded between the teeth, wrapped around the bar, and twisted to tighten.

16. To prevent the suture ends from injuring the soft tissues, a “rosebud” is made in the suture ends by grasping the wire with a hemostat and crimping it inward. The end may be buried in the patient’s gingiva.

9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS:

B A A B B B A A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF:

p. 712 p. 711 p. 712 p. 713 p. 713 p. 713 p. 711 p. 711

SOURCE: Browsegrades.net

Chapter 29: Plastic and Reconstructive Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Skin grafts that consist of the epidermis and a portion of the papillary dermis are called grafts. a. pedicle b. split-thickness c. full-thickness d. composite ANS: B A graft that contains epidermis and papillary dermis, which is a highly bioactive portion of the dermis, is a split-thickness graft.

DIF: 2.

2

REF: p. 718

are grafts that were harvested from donors and preserved by the tissue bank until needed. a. Allografts b. Autografts c. Composite grafts d. Xenografts ANS: A Allografts, also called homografts, are harvested from donors and preserved by the tissue bank until needed. Skin, bone, and cartilage are commonly used allografts.

DIF:

2

REF: p. 726

3. A rhytidectomy is typically known as a a. scar revision b. breast enhancement c. face lift d. nose job

.

ANS: C A rhytidectomy is typically known as a face lift.

DIF:

2

REF: p. 736

4. Protecting underlying tissues and organs, excreting organic waste, and storing of nutrients are functions of . a. adipose tissue b. scar formation c. mammary system d. the integumentary system ANS: D

SOURCE: Browsegrades.net

The skin, or integumentary system, performs a number of vital functions: (1) It protects underlying tissues and organs. (2) It excretes organic waste and stores nutrients. (3) It excretes water and dissipates heat as a means of thermoregulation. (4) Its sensory organs transmit touch, pressure, pain, and temperature, which alert the body to possible injury.

DIF:

2

REF: p. 719

5. Third-degree burns develop the wound site. a. bilobate b. eschar c. plicate d. imbricate

, which is devitalized, nonelastic tissue adhering to

ANS: B Third-degree burns develop eschar, which is devitalized, nonelastic tissue adhering to the wound site.

DIF:

2

REF: p. 728

6. A surgical technique in which a plane of tissue is created or an existing tissue plane is lifted, such as skin from the fascia, is called . a. stent b. plicate c. undermine d. debridement ANS: C A surgical technique in which a plane of tissue is created or an existing tissue plane is lifted, such as skin from the fascia, is called undermine.

DIF:

2

REF: p. 718

7. The most superficial layer of the epidermis is called the stratum a. corneum b. granulosum c. spinosum d. germinativum

.

ANS: A The stratum corneum is the most superficial layer of the epidermis.

DIF:

2

REF: p. 719

8. A graft derived from live tissue—human or animal—is called a(n) a. autograft b. allograft c. biological graft d. synthetic graft ANS: C

SOURCE: Browsegrades.net

.

A graft derived from live tissue—human or animal—is called a biological graft.

DIF:

2

REF: p. 718

9. During a lower lid blepharoplasty, the initial incision is made in the a. canthi of the eye b. cornea of the eye c. supraciliary region d. subciliary region

.

ANS: D The surgeon makes the incision in the subciliary region, 2 to 3 mm below the lower lash line.

DIF:

2

REF: p. 738

10. Mentoplasty is the augmentation of the a. cheeks b. forehead c. chin d. lips

.

ANS: C Mentoplasty is the augmentation of the chin.

DIF:

2

REF: p. 739

N R I G B.C M

11. When performing an otoplasU ty, tS he iN ncisT ion is mOade in the a. lower jaw b. temporal c. postauricular d. preauricular

area.

ANS: C During an otoplasty, the incision is made in the postauricular area.

DIF:

2

REF: p. 740

12. When performing a breast augmentation with an implant, the surgeon creates a pocket under the to receive the implant. a. trapezius b. rectus c. pectoralis minor d. pectoralis major ANS: D When performing a breast augmentation with an implant, the surgeon creates a pocket under the pectoralis major to receive the implant.

DIF:

2

REF: p. 742

SOURCE: Browsegrades.net

13. The procedure performed to remove excess skin and adipose tissue from the abdominal wall is called a . a. rhytidectomy b. panniculectomy c. blepharoplasty d. mentoplasty ANS: B Panniculectomy (abdominoplasty) is performed for cosmetic reduction of abdominal fat.

DIF:

2

REF: p. 748

14. A malar augmentation is a procedure used to enlarge the a. lips b. eyebrows c. cheeks d. chin

.

ANS: C A malar augmentation is a procedure used to enlarge the cheeks.

DIF:

2

REF: p. 742

15. During cheek augmentation, the incision is . a. intraoral b. intranasal c. in the subcuticular space N R I G B.C M O d. in the supratarsal crease U S N T ANS: A During cheek augmentation, the incision is intraoral.

DIF:

2

REF: p. 742

16. During removal of a superficial lesion, the skin edges are retracted with a(n) . a. Army-Navy retractor b. Beckman self-retaining retractor c. double- or single-prong skin hook d. Gelpi self-retaining retractor ANS: C During removal of a superficial lesion, the skin edges are retracted with a double- or single-prong skin hook.

DIF:

2

REF: p. 727

17. Grafts that are raised from the donor site but are not severed free are called a. pedicle b. free c. split-thickness

SOURCE: Browsegrades.net

grafts.

d. progressive ANS: A Grafts that are raised from the donor site but are not severed free are called pedicle grafts.

DIF:

2

REF: p. 733

18. Augmentation is a surgical procedure in which the a. shape; changed b. size; enlarged c. size; reduced d. surface; aligned

of a structure is

.

ANS: B Augmentation is a surgical procedure in which the size of a structure is enlarged.

DIF:

2

REF: p. 725

19. During an open brow lift, a is used to elevate the periosteum off the cranium to the level of the superior orbital rims. a. rigid cannula b. periosteal elevator c. retractor d. pin cutter ANS: B During an open brow lift, a periosteal elevator is used to elevate the periosteum off the cranium to the level of the N suU peRriS oI r oNrbGitT alBr. imCs.OM DIF:

2

REF: p. 738

20. Panniculectomy is performed to remove excess skin and adipose tissue from the a. arms b. abdomen c. cheeks d. jowls ANS: B Panniculectomy (abdominoplasty) is performed for cosmetic reduction of abdominal fat.

DIF:

2

REF: p. 748

21. Full-thickness skin graft (FTSG) contains a. only the dermis b. both dermis and epidermis c. one remodeled structure d. two or more types of tissues ANS: B A FTSG contains both dermis and epidermis.

SOURCE: Browsegrades.net

.

.

DIF:

2

22. The a. eschar b. epidermis c. keloid d. dermis

REF: p. 729 is the outer layer of the skin.

ANS: B The epidermis is the outer layer of the skin. The primary tissue cells of the epidermis are the keratinocytes.

DIF:

2

REF: p. 719

23. Aesthetic surgery, also called surgery , is performed to improve the appearance but does not always address function. a. cosmetic b. basic c. Mohs d. synthetic ANS: A Aesthetic surgery, also called cosmetic surgery, is performed to improve the appearance but does not always address function.

DIF:

2

REF: p. 718

N R I G B.CsO M kin graft.

24. A dermatome is used to harvU est aSlarN ge T a. full thickness b. split-thickness c. composite d. biosynthetic

ANS: B A dermatome is used to harvest a large split-thickness graft.

DIF: 25.

2

REF: p. 721

is the surgical removal of dead skin, debris, and infection material from a wound. a. Debridement b. Escharotomy c. Fasciotomy d. Allograft ANS: A Debridement is the process of removing dead skin, debris, and infection material from a wound..

DIF:

2

REF: p. 726

SOURCE: Browsegrades.net

26. Sharp dissection is performed with forceps. a. tenotomy b. Mayo c. rongeur d. elevator

or fine Metzenbaum scissors and toothed tissue

ANS: A Sharp dissection is performed with tenotomy or fine Metzenbaum scissors and toothed tissue forceps.

DIF:

2

REF: p. 720

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Liposuction b. Laser c. Mesher d. Dermatome e. Brow lift 1.

2.

3.

4.

5.

6.

Used to take autograft skin Rigid cannulas that are connected to large-bore suction tubing Used to increase the surface area of grafted skin by puncturing holes into the skin graft .aCyObMe used The corneal, pretrichial, orN diU reR ctSaI ppNrG oaT chBm Used to aerate a skin graft Aspiration of adipose tissue

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS:

D A C E C A

DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3

REF: REF: REF: REF: REF: REF:

p. 721 p. 748 p. 725 p. 738 p. 725 p. 748

Choose from the specialty procedures and match them with their most correct description.

You may use the same answer more than once. a. Mammoplasty b. Panniculectomy c. Rhytidectomy d. Skin graft 7.

8.

9.

10.

11.

Performed to change the size of the breast Performed to rejuvenate an aging face Performed to reconstruct the breast without the use of implants A stent dressing is used Performed to excise the excess abdominal wall skin

SOURCE: Browsegrades.net

12. Usually performed after significant weight loss 13. Requires the use of a tissue expander under certain conditions 14. Performed to treat macromastia 7. ANS: 8. ANS: 9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS:

A C A D B B A A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF:

p. 742 | p. 744 p. 739 p. 744-745 p. 725 p. 748 p. 748 p. 744-745 p. 744

SOURCE: Browsegrades.net

Chapter 30: Orthopedic Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The middle shaft of the long bone is called the a. diaphysis b. epiphysis c. periosteum d. crest

.

ANS: A The diaphysis is the middle shaft of the long bone.

DIF:

2

REF: p. 753

2. The patella is an example of a a. sesamoid b. long c. short d. flat

bone.

ANS: A The patella is an example of a sesamoid bone.

DIF:

2

G B.C M U S N T O

REFN : pR . 75I 3

3. The part of a long bone is very dense and is found on the outside. a. cortical b. cancellous c. bone marrow d. periosteum ANS: A The cortical part of a long bone is very dense and is found on the outside.

DIF:

2

REF: p. 753

4. A rounded orifice in bone or a passageway for blood vessels or nerves is known as a . a. foramen b. tuberosity c. spine d. process ANS: A A rounded orifice in bone or a passageway for blood vessels or nerves is known as a foramen.

DIF:

2

REF: p. 755

SOURCE: Browsegrades.net

5. a. b. c. d.

protect(s) the bone surface and provide(s) attachment for tendons.

The endosteum The periosteum The marrow Red blood cells

ANS: B The periosteum protects the bone surface and provides attachment for tendons.

DIF:

2

REF: p. 753

6. A knuckle-shaped portion of bone, generally found in association with a joint, is called a . a. condyle b. crest c. spine d. process ANS: A A knuckle-shaped portion of bone, generally found in association with a joint, is called a condyle.

DIF:

2

REF: p. 755

7. During , the glenoid rim is reattached to the joint capsule with a biosynthetic or other anchoN ringRdevice wi. thCheaMvy sutures.

INGorTB U S O a. plating of the proximal humerus b. shoulder arthroscopy c. the Bankart procedure d. carpal tunnel release ANS: C In the Bankart procedure, the glenoid rim is reattached to the joint capsule with a biosynthetic or other anchoring device or with heavy sutures.

DIF:

2

REF: p. 776

8. The surgical goal of a Bankart procedure is to . a. restore stability to the shoulder joint and to alleviate pain b. surgically repair a fracture of the distal humerus c. correct the metacarpophalangeal (MCP) joint that has deteriorated because of rheumatic arthritis d. correct a recurrent anterior dislocation of the shoulder ANS: D The surgical goal of a Bankart procedure is to correct a recurrent anterior dislocation of the shoulder.

DIF:

2

REF: p. 776

SOURCE: Browsegrades.net

9. The orthopedic table (also called a fracture table) is used mainly for surgery of the . a. wrist and hand b. ankle and foot c. femur and lower leg d. shoulder and humerus ANS: C The orthopedic table (also called a fracture table) is used mainly for surgery of the femur and lower leg.

DIF: 10. a. b. c. d.

2

REF: p. 757

is used in first-level assessment for most orthopedic trauma.

CT scans MRI Angiography X-ray

ANS: D X-ray is used in first-level assessment for most orthopedic trauma.

DIF: 11. a. b. c. d.

2

REF: p. 756

fractures are fractures in which the bone penetrates the skin.

Greenstick Open Spiral Transverse

ANS: B Open fractures are fractures in which the bone penetrates the skin.

DIF:

2

REF: p. 759

12. A fracture caused by disease is called a(n) a. pathological fracture b. metastatic fracture c. bone tumor d. open fracture

.

ANS: A A fracture caused by disease is called a pathological fracture.

DIF:

2

13. The a. wrist b. elbow c. hip d. knee

REF: p. 759 is the most complicated joint of the body, vulnerable to a variety of injuries.

SOURCE: Browsegrades.net

ANS: D The knee is the most complicated joint of the body, vulnerable to a variety of injuries.

DIF:

2

REF: p. 796

14. A(n) blade is fixed at a right angle (90 degrees) to the handpiece and moves along a perpendicular axis. a. reamer b. reciprocating saw c. sagittal saw d. oscillating saw ANS: C A sagittal saw blade is fixed at a right angle to the handpiece and moves along a perpendicular axis.

DIF:

2

REF: p. 762

15. K-wires and Steinmann pins are inserted directly into the tissue using a. a hammer b. a drill c. a screwdriver d. IM rodding ANS: B Wires are used and are inserted with the power drill.

DIF: 16. a. b. c. d.

2

REF: p. 771

requires the use of orthopedic implants.

Open reduction internal fixation Closed reduction Closed reduction with plaster casting Application of a hip spica

ANS: A An open reduction internal fixation requires the use of orthopedic implants.

DIF:

2

REF: p. 760

17. An orthopedic drill is similar to a a. carpenter’s b. dental c. miner’s d. construction

drill.

ANS: A An orthopedic drill is similar to a carpenter’s drill.

DIF:

2

REF: p. 761

SOURCE: Browsegrades.net

.

18. a. b. c. d.

Elevators are used to lift the . bone marrow away from the compact bone periosteum from the surface of the bone cartilage from surface to bone muscle from the surface of bone

ANS: B An elevator’s main function is to remove or scrape away the periosteum (the tough outer membrane of the bone) from the bone surface.

DIF:

2

REF: p. 766

19. Whenever power-driven cutting instruments are in use, the scrub should a. lightly irrigate the cutting blade b. hand up a lap sponge to dry off the blade c. provide irrigation to the surgical site d. hand up an irrigation syringe with the power device

.

ANS: A Irrigation solution is always used with power drills and saws.

DIF:

2

REF: p. 761

20. During arthroscopy, tubing and continuous flushing of the joint. a. inflow; outflow b. external; internal c. small; big d. backflow; inflow

tubing are required to maintain

ANS: A Inflow tubing and outflow tubing are required to maintain continuous flushing of the joint.

DIF: 21. a. b. c. d.

2

REF: p. 775

and cutters are used for trimming and modeling bone and cartilage.

Rongeurs; bone Elevators; bone Rasps; bone Bone hooks; bone

ANS: A Rongeurs and bone cutters are used for trimming and modeling bone and cartilage.

DIF:

2

REF: p. 765

22. Cancellous bone . a. is found on the surface of bones and is organized by tubular units called osteons b. resembles a sponge and the spaces are filled with red or yellow marrow, a soft connective tissue

SOURCE: Browsegrades.net

c. is stronger than cortical bone. d. serves to support and protect.

ANS: B Cancellous bone resembles a sponge and the spaces are filled with red or yellow marrow, a soft connective tissue.

DIF:

2

REF: p. 753

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Hand instrument b. Power equipment c. Orthopedic implant d. Joint replacement implant 1.

2.

3.

4.

5.

6.

7.

8.

Made from ceramic material Sagittal saw Rongeurs and bone cutters Used to scrape away periosteum from bone surface Screws made of titanium or stainless steel Components used to replace the diseased or injured tissue Devices used to attach or fix bone and other connective tissue Bone-holding clamp

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS:

D B A A C D C A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF:

p. 772 p. 762 p. 765 p. 766 p. 767 p. 771 p. 766 p. 762

Choose from the terms listed and match them with their most correct description. a. Process b. Sinus c. Fossa d. Spine e. Tubercle f. Crest g. Neck h. Sulcus i. Foramen j. Tuberosity k. Condyle

SOURCE: Browsegrades.net

9. A knuckle-shaped portion of bone generally found in association with a joint 10. A ridge of bone (e.g., iliac crest) 11. A rounded orifice in a bone (e.g., olfactory foramen); usually a passageway for blood vessels or nerves 12. A depression in a bone (e.g., iliac fossa) 13. A narrow bridge of bone between two other structures (e.g., neck of the femur, neck of the humerus) 14. A projection of bone (e.g., coracoid process) 15. A cavity within a bone (e.g., nasal sinus) 16. A sharp, narrow projection (e.g., spinous process) 17. A groove in a bone 18. A small, rounded projection (e.g., deltoid tubercle) 19. A large, rounded projection (e.g., ischial tuberosity) 9. ANS: K 10. ANS: F 11. ANS: I 12. ANS: C 13. ANS: G 14. ANS: A 15. ANS: B 16. ANS: D 17. ANS: H 18. ANS: E 19. ANS: J

DIF: 3 REF: p. 755 DIF: 3 REF: p. 755 DIF: 3 REF: p. 755 DIF: 3 REF: p. 755 DIF: 3 REF: p. 755 DIF: 3 REF: p. 755 DIF: 3 REF: p. 755 DIF: 3 REF: p. 755 DIF: 3 REF: p. 755 DIF: 3 REF: p. 755 DIF:NU3RSINGTB.RC EO F:M p. 755

Choose from the terms listed and match them with their most correct description. a. Impacted b. Transverse c. Oblique d. Spiral e. Greenstick f. Open g. Comminuted 20. The fracture line is perpendicular to the long axis of the bone 21. A type of transverse fracture that occurs at an angle 22. A fracture of the long bone that occurs in a spiral pattern as the result of twisting or torsion on the bone 23. A fracture in which bone fragments are driven into each other or into another bone 24. A fracture with two or more pieces 25. A fracture in which the fractured end penetrates the skin 26. A fracture of immature bone that is soft and less brittle than mature bone 20. ANS: B 21. ANS: C 22. ANS: D

DIF: DIF: DIF:

3 3 3

REF: p. 759 REF: p. 759 REF: p. 759

SOURCE: Browsegrades.net

23. ANS: 24. ANS: 25. ANS: 26. ANS:

A G F E

DIF: DIF: DIF: DIF:

3 3 3 3

REF: REF: REF: REF:

p. 759 p. 759 p. 759 p. 759

SOURCE: Browsegrades.net

Chapter 31: Peripheral Vascular Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. During hemodialysis, the patient’s blood is shunted outside the body through an artery. a. etiology b. parenchyma c. in situ d. extracorporeal ANS: D During extracorporeal hemodialysis, the patient’s blood is shunted outside the body through an artery.

DIF:

2

REF: p. 832

2. An incision made in the artery is called an a. arteriovenous (AV) fistula b. arteriotomy c. arteriotomy d. arteriogram ANS: B Arteriotomy is an incision N intoRtheI arteG ry. B.C

U S N T

DIF:

2

.

M O

REF: p. 824

3. A blood clot, air, or organic material that is free flowing in the vascular system is known as a(n) . a. thrombus b. infarction c. embolus d. ischemia ANS: C An embolus is a blood clot, air, or organic material that is free flowing in the vascular system.

DIF:

2

REF: p. 811

4. A reduction in the patient’s total blood volume is called a. hyperthermia b. hypocoagulation c. hypervolemia d. hypovolemia ANS: D Hypovolemia is a precipitous drop in blood or fluid volume.

SOURCE: Browsegrades.net

.

DIF:

2

REF: p. 814

5. Intravenous (IV) administration of thrombin can cause a(n) a. fatal embolus b. postoperative hemorrhage c. clot to form at the vascular anastomosis site d. intraoperative hemorrhage

.

ANS: A Accidental IV administration of thrombin can cause a fatal embolus.

DIF:

2

REF: p. 824

6. Which of the following anatomical structures make up the peripheral vascular system? a. Arteries, veins, and capillary networks b. Heart, lungs, arteries, and veins c. Heart, arteries, veins, and capillary networks d. Arteries and veins ANS: A The major organs of this system are the arteries, veins, and capillaries.

DIF: 7. a. b. c. d.

2

REF: p. 812

is administered to reverse the effects of systemic heparin.

Neostigmine Vasopressin Protamine sulfate Premarin

ANS: C Systemic heparin is reversed with protamine sulfate, which is administered by the anesthesia care provider.

DIF:

2

REF: p. 824

8. Ischemia of tissue may be caused by _ a. loss of sensation to the tissue b. loss of blood to the tissue c. pain originating from dead tissue d. death of the tissue

.

ANS: B The decrease in or absence of blood supply to a localized area, usually related to vascular obstruction, causes ischemia of tissue.

DIF:

2

REF: p. 812

9. The injection of contrast media into a selected artery and its branches to determine the exact location of strictures, occlusion, or malformation is called .

SOURCE: Browsegrades.net

a. b. c. d.

angioplasty angiography venotomy arteriotomy

ANS: B Angiography is radiographic imaging of the artery.

DIF:

2

REF: p. 819

10. A direct anastomosis between an artery and a vein is called a(n) a. hemodialysis fistula b. arteriovenous graft c. hemodialysis graft d. AV fistula

.

ANS: D An AV fistula is a direct anastomosis between an artery and a vein.

DIF:

2

REF: p. 832

11. A metal, umbrella-shaped filter is inserted into the entering the pulmonary system. a. inferior vena cava b. ascending aorta c. descending aorta d. superior vena cava

to prevent emboli from

ANS: A A vena cava filter is a metal, umbrella-shaped filter inserted into the inferior vena cava to prevent emboli from entering the pulmonary system.

DIF:

2

12.

REF: p. 831 is the removal of a fatty fibrotic plaque that develops in the intimal layer

of the arteries. a. Endarterectomy b. Embolectomy c. Thrombectomy d. Angioplasty ANS: A Endarterectomy is the removal of a fatty fibrotic plaque that develops in the intimal layer of the arteries.

DIF:

2

REF: p. 835

13. The medical term that means “in its normal position” is a. in situ b. emboli c. ischemia

SOURCE: Browsegrades.net

.

d. thromboembolic ANS: A The medical term that means “in its normal position” is in situ.

DIF:

2

REF: p. 811

14. A bifurcated graft is a. Y-shaped b. straight c. not used in vascular surgery d. rarely used in vascular surgery

.

ANS: A Grafts may be straight or bifurcated (Y-shaped).

DIF:

2

15. A(n) a. embolus b. plaque c. thrombus d. thrombin

REF: p. 824 is a stationary clot in the arterial or venous system.

ANS: C A thrombus is a stationary clot in the arterial or venous system.

DIF:

2

.8 REFN : UpR S3I4NGTB.COM

16. Pulse volume recording (arterial plethysmography) requires reading(s). a. one b. two c. three d. four

blood pressure cuff

ANS: C Each cuff reading produces a waveform, which is compared with the waveforms from the other two cuffs.

DIF:

2

REF: p. 819

17. The largest vein of the body is the a. iliac vein b. renal vein c. portal vein d. vena cava

.

ANS: D The vena cava is the largest vein in the body.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 816

18. The elastic nature of the arteries allows them to diastole to maintain vascular pressure. a. relax; contract b. contract; relax c. collapse; relax d. contract; collapse

during systole and

during

ANS: B The elastic nature of the arteries allows them to contract during systole (ventricular contraction) and relax during diastole (the resting phase of the heart) to maintain vascular pressure.

DIF:

2

REF: p. 813

19. The tunica externa (also called the ), which is composed of connective tissue, protects the vessel from injury and provides structural strength. a. adventitia b. externa c. adnexa d. media ANS: A The tunica externa (also called the adventitia), which is composed of connective tissue, protects the vessel from injury and provides structural strength.

DIF:

2

N R I G B.COM

REF: Up. 8S12N T

20. Arterial plaque is identified as a thick, yellow, rubbery material that adheres to the lumen ( layer) of the artery. a. media b. intimal c. interstitial d. enteric ANS: B Arterial plaque is identified as a thick, yellow, rubbery material that adheres to the lumen (intimal layer) of the artery.

DIF:

2

REF: p. 836

21. Obstruction or stenosis of an artery commonly forms at the a. bifurcations b. origins c. anomalies d. intima ANS: A

SOURCE: Browsegrades.net

.

In peripheral atherosclerosis, fatty plaque and calcium are deposited on the tunica intima, causing stenosis and loss of circulation. Areas of plaque are most dense near arterial bifurcations.

DIF:

2

REF: p. 845

22. In situ saphenous vein bypass is a surgical alternative to using a diseased femoral artery. a. synthetic graft b. stent c. balloon d. catheter

to bypass a

ANS: A A synthetic graft is tunneled through the subcutaneous tissue from the axillary incision to the femorofemoral graft.

DIF:

2

REF: p. 841

23. Femorofemoral bypass is performed to bypass unilateral atherosclerotic disease in the artery. a. splenic b. iliac c. femoral d. jugular ANS: B Femorofemoral bypass is performed to bypass unilateral atherosclerotic disease in the iliac artery.

DIF:

2

REF: p. 841

24. Abdominal aortic aneurysm is a condition in which a section of the abdominal aorta becomes . a. thickened and structured b. thin and bulges c. thin and flaky d. thick and hard ANS: B An abdominal aortic aneurysm is a condition in which a section of the abdominal aorta becomes thin and bulges because of atherosclerotic plaque and progressive weakening of the aortic wall.

DIF:

2

REF: p. 837

MATCHING Choose from the terms listed and match them with their most correct description. You may use the same answer more than once.

SOURCE: Browsegrades.net

a. b. c. d.

1.

2.

3.

4.

5.

6.

7.

Arteriotomy Atherosclerosis Endarterectomy Angioplasty

An incision made in the artery The surgical removal of atherosclerotic plaque from inside an artery May use a vascular stent May use a vascular shunt Most common form of arteriosclerosis Made with a #11 scalpel blade Performed during angiography

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS:

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

A C D C B A D

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF:

p. 824 p. 811 p. 829 p. 836 p. 811 p. 834 p. 819

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Vein b. Lymphatic c. Artery Carries oxygenated blood from the heart Carries nutrients from the digestive system into the liver Produces lymphocytes Inferior vena cava Thick-walled and highly elastic Occurs in groups or chains Blood pumped by skeletal muscles Common carotid Composed of ducts Carries blood back to the heart

8. ANS: 9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS:

C A B A C B A C B

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 812 p. 816 p. 816 p. 816 p. 813 p. 816 p. 813 p. 816 p. 816

SOURCE: Browsegrades.net

17. ANS: A

DIF:

3

REF: p. 812

SOURCE: Browsegrades.net

Chapter 32: Thoracic and Pulmonary Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Thoracic and surgery includes procedures of the thoracic cavity, excluding those that involve the heart and cardiac vessels. a. pulmonary, endocrine b. cardiac, respiratory c. pulmonary, respiratory d. none of the above

system and

ANS: C Thoracic and pulmonary surgery includes procedures of the respiratory system and thoracic cavity, excluding those that involve the heart and cardiac vessels.

DIF:

2

2.

REF: p. 846 is bloody sputum or bleeding arising from the respiratory tract.

a. b. c. d.

Empyema Hemoptysis Hypoxia Pleuritis

ANS: B Hemoptysis is bloody sputuNm oRr bI leedG ingB ar. isC ing M from the respiratory tract.

U S N T

DIF:

2

O

REF: p. 846

3. With the patient in the position, it is necessary to position a magnetic instrument pad over the top drape to serve as a neutral zone and to retain any instruments that are placed on the drape. a. prone b. lateral c. supine d. dorsal recumbent ANS: B With the patient in lateral position, it is necessary to position a magnetic instrument pad over the top drape to serve as a neutral zone and also to retain any instruments that are placed on the drape.

DIF: 4.

2

REF: p. 851

of one or both lungs is performed to remove a diseased lung and replace it with a donor lung. a. Donors b. Transplantation c. Transferred

SOURCE: Browsegrades.net

d. A and B ANS: B Transplantation of one or both lungs is performed to remove a diseased lung and replace it with a donor lung.

DIF:

2

REF: p. 864

5. The surgical removal of a portion of the parietal pleura is called a. lung volume reduction b. pneumonectomy c. decortication of the lung d. lobectomy

.

ANS: C Decortication of the lung is the surgical removal of a portion of the parietal pleura.

DIF:

2

REF: p. 863

6. The procedure that removes an entire lung to debulk (reduce the size of) a malignant tumor is called a . a. lobectomy b. pneumonectomy c. decortication of the lung d. lung volume reduction ANS: B Pneumonectomy is the remN ovUaR l oSfI thNeG enTtiB re.lC unO gM .

DIF:

2

REF: p. 862

7. The nerves are carefully preserved during pneumonectomy. a. vagus, left recurrent laryngeal, and phrenic b. vagus, pneumatic, and phrenic c. phrenic, pneumatic, and epigastric d. pneumatic, vagus, and left recurrent laryngeal ANS: A The vagus, phrenic, and left recurrent laryngeal nerves are identified and preserved.

DIF:

2

8. The a. bronchi b. hilum c. trachea d. pharynx

REF: p. 862 begin(s) at the larynx and branch(es) into two main airways.

ANS: C The trachea begins at the larynx and branches into two main airways.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 847

9. During a pulmonary function test, the total volume of air is exhaled after maximum inspiration. This is called . a. tidal volume b. vital capacity c. total lung capacity d. minute volume ANS: B Vital capacity is the total volume of air exhaled after maximum inspiration.

DIF:

2

REF: p. 851

10. Bronchoscopy is the insertion of a flexible fiberoptic or rigid telescope into the a. trachea b. mediastinum c. pleura d. thoracic cavity

.

ANS: A A bronchoscopy is the insertion of a flexible fiberoptic or rigid telescope into the trachea.

DIF:

2

REF: p. 854

11. When a thoracotomy is performed, the edges of the wound are covered with laparotomy sponges to protect the wouN nd eR dgeI s froGm B.C M .

U S N T O a. hemorrhaging b. sticking c. drying d. bruising ANS: D The edges of the wound are covered with laparotomy sponges to protect them from bruising.

DIF:

2

REF: p. 861

12. Decortication of the lung is the surgical removal of a portion of the a. pericardium b. parietal pleura c. diaphragm d. visceral pleura ANS: B Decortication of the lung is the surgical removal of a portion of the parietal pleura.

DIF:

2

13.

REF: p. 863 is defined as difficulty in breathing.

a. Hypoxia b. Empyema

SOURCE: Browsegrades.net

.

c. Dyspnea d. Pleuritis ANS: C Dyspnea is difficulty in breathing.

DIF:

2

REF: p. 846

14.

is the loss of elasticity and distention of the alveoli. a. b. c. d.

Emphysema Fibrosis Pleural effusion Sarcoidosis

ANS: A Diseases that constrict the alveoli, such as emphysema, cause loss of alveolar elasticity. The result is inability to exchange oxygen with carbon dioxide.

DIF: 15. a. b. c. d.

2

REF: p. 860

requires 10-mm lenses in sizes 0 and 30 degrees.

Rigid bronchoscopy Mediastinoscopy Thoracoscopy Flexible bronchoscopy

ANS: C GT Thoracoscopy in an adult rN eqU uiR reS sI 10N-m mB le. nC seO s iM n sizes 0 and 30 degrees.

DIF:

2

16.

REF: p. 858 is the distribution of oxygen to the tissue.

a. b. c. d.

Diffusion Ventilation Respiration Perfusion

ANS: D Perfusion (oxygen) is the distribution of oxygen to tissues.

DIF: 17. a. b. c. d.

2

REF: p. 846

is generally used only for the removal of large tissue or a foreign body.

Rigid bronchoscopy Flexible bronchoscopy Mediastinoscopy Thoracoscopy

ANS: A Rigid bronchoscopy is used for interventional procedures, which require a large-bore endoscope and rigid instruments, such as removal of a tissue mass or a foreign body.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 854

18. With a thoracotomy, the shoulder muscles are retracted using a a. wide Deaver b. scapular retractor c. ribbon retractor d. Finochietto retractor

_.

ANS: B During a thoracotomy, a scapular retractor should be available to retract shoulder muscles.

DIF:

2

REF: p. 861

19. Pulmonary angiography is performed when computed tomography (CT) scans are inconclusive for diagnosis of . a. pulmonary infusion b. obstructive pulmonary disease c. pulmonary embolism d. spontaneous pneumothorax ANS: C Pulmonary angiography is performed when CT scans are inconclusive for diagnosis of pulmonary embolism.

DIF:

2

REF: p. 851

N R I G B.C M

20. Patients who undergo a VATU S teS chnN iqueTfor resO ection of blebs may be placed on mechanical in the immediate postoperative period. a. ventilation b. hypoventilation c. hyperventilation d. diffusion ANS: A Patients who undergo a VATS technique for resection of blebs may be placed on mechanical ventilation in the immediate postoperative period.

DIF:

2

REF: p. 860

21. A pneumothorax is air in the chest cavity that prevents the lungs from expanding and may . a. displace the mediastinal structures b. collapse the contralateral lung c. inflate the contralateral lung d. cause bilateral lung inflation ANS: A A pneumothorax is air in the chest cavity that prevents the lungs from expanding and may displace the mediastinal structures.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 841

22. The reason inhaled foreign material is more likely to enter the right lung is because the right bronchus is than the left. a. larger b. straighter c. smaller d. longer ANS: B Because the right bronchus is straighter than the left, inhaled foreign material is more likely to enter the right lung.

DIF:

2

REF: p. 847

23. When the diaphragm , the potential space between the two pleural membranes is decreased and air is pulled into airways and lungs. a. expands b. contracts c. closes d. opens ANS: B When the diaphragm contracts during inhalation, the potential space between the two pleural membranes decreases, and air is pulled into the airways and lungs.

DIF:

2

G B.C M U S N T O

REFN : pR . 84I 9

24. The lung is divided into anatomical regions. The right lung has has lobes. a. two, three b. three, two c. four, three d. three, four

lobes and the left lung

ANS: B The lung is divided into anatomical regions. The right lung has three lobes, and the left lung has two lobes.

DIF:

2

REF: p. 847

25. Diffusion is the transfer of oxygen from the a. bronchi in the lungs to the alveoli b. alveoli in the lungs to the bloodstream c. capillaries to the alveoli in the lungs d. alveoli in the lungs to the capillaries

.

ANS: B Diffusion is the transfer of oxygen from the alveoli in the lungs to the bloodstream.

DIF:

2

REF: p. 846

SOURCE: Browsegrades.net

26. An arterial blood gas test assesses the arterial blood for a. red and white blood cells and platelets b. oxygen and carbon dioxide levels, as well as pH c. pH of blood only d. number of red and white blood cells and platelets

.

ANS: B In this test, the arterial blood is assessed for oxygen levels, carbon dioxide levels, and pH (acid-base balance).

DIF:

2

REF: p. 851

27. The patient is placed in semi-Fowler position to perform a a. rigid b. flexible c. laparoscopic d. open

bronchoscopy.

ANS: B In a flexible bronchoscopy, the patient is placed in a semi-Fowler position.

DIF:

2

REF: p. 856

MATCHING

IaNtcGhTthBem .CwO Choose from the terms listeNdUaR ndSm ithMtheir most correct description. You may use the same answer more than once. a. Bronchoscopy b. Mediastinoscopy c. Thoracoscopy 1.

2.

3.

4.

5.

6.

7.

8.

9.

A small portion of lung tissue is removed for pathological assessment Uses a 10-mm, 0-degree, and 30-degree lens Uses a stainless steel endoscope inserted through a small incision at the suprasternal notch Lymph node biopsy is performed routinely during the procedure Used to remove foreign body from airway Inserts a scope into the trachea Used to perform a lung biopsy Can be either rigid or flexible Uses trocars and cannulas

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS:

C C B B A A C

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF:

p. 858 p. 858 p. 856 p. 856 p. 854 p. 854 p. 858

SOURCE: Browsegrades.net

8. ANS: A 9. ANS: C

DIF: DIF:

3 3

REF: p. 854-855 REF: p. 858

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Pneumothorax b. Hemothorax c. Pulmonary embolism d. Emphysema 10.

11.

12.

13.

14.

Loss of elasticity and distention of the alveoli Blood in the pleural cavity Air enters the pleural cavity Lung volume reduction surgery is used to treat Results in abnormal overinflation of the lungs

10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS:

D B A D D

DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3

REF: REF: REF: REF: REF:

p. 860 p. 849 p. 849 p. 860 p. 860

SOURCE: Browsegrades.net

Chapter 33: Cardiac Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The heart is contained within a closed cavity called the a. mediastinum b. pleural space c. chest cavity d. thoracic outlet

.

ANS: A The heart is contained within a closed cavity called the mediastinum.

DIF:

2

REF: p. 867

2. The sinoatrial (SA) node initiates the cardiac cycle and is sometimes called the heart’s . a. electrode b. pacemaker c. generator d. alligator clamp ANS: B The SA node initiates the cardiac cycle and is sometimes called the heart’s pacemaker.

DIF:

2

N R I G B.COM

REF: Up. 8S68N T

3. Fibrillation is . a. a disturbance to the heartbeat b. a heart valve that is unable to close tightly c. a fast heart rate d. uncoordinated muscular activity in the heart muscle, which results in “quivering” rather than pumping action ANS: D Fibrillation is uncoordinated muscular activity in the heart muscle, which results in “quivering” rather than pumping action.

DIF:

2

REF: p. 866

4. Chaotic, disorganized stimulation of one or both ventricles that does not pump the blood is called . a. ventricular fibrillation. b. tachycardia. c. bradycardia. d. atrial septal defect.

ANS: A

SOURCE: Browsegrades.net

Chaotic, disorganized stimulation of one or both ventricles that does not pump the blood is called ventricular fibrillation.

DIF: 5.

2

REF: p. 897

demonstrates the movement of blood through the valves and can be used to measure the ejection fraction and end-systolic and end-diastolic volumes. a. Ventricular angiography b. Electrophysiology c. Mediastinoscopy d. Computed tomography (CT) scan ANS: A Ventricular angiography demonstrates the movement of blood through the valves and can be used to measure the ejection fraction (the amount of blood pumped from the ventricles) and end-systolic and end-diastolic volumes.

DIF:

2

REF: p. 870

6. The coronary artery is opened with a #11 knife blade (or Beaver blade), and the incision is extended with coronary scissors. a. Potts b. Metz c. tenotomy d. micro ANS: A The coronary artery is opened with a #11 knife blade (or Beaver blade), and the incision is extended with Potts coronary scissors.

DIF: 7.

2

REF: p. 883

is reduced blood supply to tissue, which may be a result of obstruction within the blood vessels or external pressure, which acts as a tourniquet. a. Ischemia b. Infarction c. Mediastinum d. Stenosis ANS: A Ischemia is reduced blood supply to tissue. Ischemia may be a result of obstruction within the blood vessels or external pressure, which acts as a tourniquet.

DIF:

2

REF: p. 866

8. A pacemaker is a device that produces electrical impulses that stimulate the heart. This process is called . a. pacing the heart b. stabilizing the heart c. decreasing a high heart rate

SOURCE: Browsegrades.net

d. repairing a non–life-threatening dysrhythmia ANS: A A pacemaker is a device that produces electrical impulses that stimulate the heart muscle.

This process is called pacing the heart.

DIF:

2

REF: p. 876

9. Bradycardia is a heart rate a. below 40 to 60 b. of 70 to 100 c. of 60 to 120 d. higher than 120

beats per minute.

ANS: A A heart rate below 40 to 60 beats per minute is bradycardia.

DIF: 10.

2

REF: p. 897

is the most common incision used for surgical procedures of the heart and great vessels in the thoracic cavity. a. Transverse sternotomy b. Median sternotomy c. Anterior lateral thoracotomy d. Posterior lateral thoracotomy ANS: B A median sternotomy incisN ioU nR isSmIaN deGtoTeBx. poCsO eM the heart and great vessels.

DIF:

2

REF: p. 870

11. Cardioplegia solution is used to a. stop the heart’s pumping action b. reverse the effect of heparin c. prevent blood clots from forming d. treat ventricular arrhythmias

.

ANS: A Cardioplegia is intentional stopping of the heart during cardiac surgery. This is achieved with a cardioplegic solution, which often contains a mixture of potassium chloride, lidocaine, dextrose, insulin, albumin, tromethamine, and plasmanate.

DIF:

2

REF: p. 877

12. The aortic valve maintains one-way blood flow from the a. right ventricle b. left atrium c. right atrium d. left ventricle ANS: D

SOURCE: Browsegrades.net

to the aorta.

The left ventricle receives oxygenated blood from the left atrium. From the left ventricle, the blood is pumped into the aorta and the systemic circulation. The valves of the heart maintain one-way flow through the cardiac chambers.

DIF:

2

REF: p. 887

13. During an aortic valve replacement, a open the aorta. a. transverse b. brachial c. median sternotomy d. lateral thoracotomy

incision is most commonly made to

ANS: A A transverse incision is made in the anterior aortic wall.

DIF:

2

REF: p. 889

14. The mitral valve is located between the a. left atrium and the aorta b. right atrium and vena cava c. left atrium and left ventricle d. right atrium and right ventricle

.

ANS: C The mitral valve is situated between the left atrium and left ventricle.

DIF:

2

N R I G B.COM

REF: Up. 8S68-N869T

15. During coronary artery bypass surgery, the surgeon occludes the ascending aorta and inserts the indwelling catheter for . a. infusion of cardioplegic solution and venting of air b. infusion of heparin solution and injection of air c. infusion of anesthetic solutions and injection of air d. infusion of potassium solution and injection of air ANS: A The surgeon then occludes the ascending aorta and inserts the indwelling catheter for infusion of cardioplegic solution and venting of air.

DIF:

2

REF: p. 883

16. Removal of the native heart and replacement with a donor heart is indicated for patients with cardiac disease. a. end-stage b. chronic c. continuous d. early-stage ANS: A Heart transplant may be performed in suitable patients with end-stage cardiac disease.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 900

17. Two classifications of aneurysms are a. saccular and fusiform b. stenotic and syncope c. aortic and ventricular d. cranial and caudal

.

ANS: A Aneurysms can be classified as saccular or fusiform. A saccular aneurysm is a ballooning out of a localized area in the artery. A fusiform aneurysm involves the entire circumference of the artery.

DIF:

2

REF: p. 892

18. An artificial pacemaker is implanted in the body to correct cardiac arrhythmia caused by . a. stenosis of the great vessels b. disease of the conduction system c. hardening of heart vessels d. hardening of the heart valves ANS: B An artificial pacemaker is implanted in the body to correct cardiac arrhythmia caused by a disease of the conduction system.

DIF:

2

N R I G B.COM

REF: Up. 8S97N T

19. Tachycardia is a fast heart rate, usually more than a. 90 b. 80 c. 65 d. 120

beats per minute.

ANS: D Tachycardia is a fast heart rate usually more than 120 beats per minute.

DIF:

1

REF: p. 897

20. The three layers of the wall of the heart are the outer epicardium, the middle myocardium, and the inner . a. pericardium b. endocardium c. cryocardium d. intracardium ANS: B The three layers of the wall of the heart are the outer epicardium, the middle myocardium, and the inner endocardium.

SOURCE: Browsegrades.net

DIF:

1

REF: p. 867

21. Cardiac catheterization is a(n) procedure and involves insertion of a cardiac catheter into the heart chambers and large vessels via a peripheral artery or vein. a. open operative b. interventional radiology c. noninvasive d. difficult ANS: B Cardiac catheterization is an interventional radiology procedure and involves insertion of a cardiac catheter into the heart chambers and large vessels via a peripheral artery or vein.

DIF:

2

REF: p. 868-869

22. The Rumel tourniquet, commonly used in cardiovascular surgery, is a short length of rubber tubing either commercially prepared or cut from a(n) . a. Penrose drain b. T-tube drain c. straight (Robinson) urinary catheter d. unused section of suction tubing ANS: C The Rumel tourniquet, commonly used in cardiovascular surgery, is a short length of rubber tubing either commercially prepared or cut from a straight (Robinson) urinary catheter.

DIF:

1

G B.C M U S N T O

REFN : pR . 87I 1

23. A midline incision from the sternal notch 2 to 3 inches below the xiphoid is called a(n) sternotomy. a. median b. paramedian c. anterolateral d. transverse ANS: A A midline incision from the sternal notch to 2 to 3 inches below the xiphoid is called a median sternotomy.

DIF:

1

REF: p. 877

MATCHING Match the following dysrhythmias with the best description of the anomaly. You may use the same answer more than once. a. Ventricular fibrillation b. Atrial flutter c. Bradycardia d. Ventricular tachycardia e. Atrial fibrillation

SOURCE: Browsegrades.net

1.

2.

3.

4.

Heart rate over 120 beats per minute Heart rate of 240 to 450 beats per minute Chaotic, disorganized stimulation of the ventricle(s) that does not pump the blood Chaotic, disorganized stimulation of the atrium (atria) that prevents atrial contraction (which helps fill the ventricle with blood) 5. Abnormally slow heartbeat below 60 beats per minute 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

D B A E C

DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3

REF: REF: REF: REF: REF:

p. 897 p. 897 p. 897 p. 897 p. 897

Choose from the terms listed and match them with their most correct description. You may use the same answer more than once. a. Right ventricle b. Right atrium c. Bicuspid (mitral) valve d. Left ventricle e. Left atrium f. Tricuspid valve 6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Located on the right side of the heart between the ventricle and the atrium Receives deoxygenated blood from the right atrium Pumps oxygenated blood to the body Between the left atrium andNlU efR t vSeI ntN riG clT e B.COM A diseased mitral valve is replaced to prevent blood from regurgitating here Replaced with a prosthetic valve through a right atriotomy Receives deoxygenated blood from the body Connected to the pulmonary artery by the pulmonary valve Disease may be caused by rheumatic heart disease Connects to the aorta by the aortic valve

6. ANS: 7. ANS: 8. ANS: 9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS:

F A D C E F B A C D

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 867 p. 868 p. 868 p. 868 p. 889 p. 892 p. 868 p. 868 p. 889 p. 867

SOURCE: Browsegrades.net

Chapter 34: Pediatric Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. Pediatric surgery is a multidisciplinary field that encompasses many surgical specialties.

Most procedures can be classified into one of three groups, including all of the following, EXCEPT . a. trauma surgery b. treatment of disease c. treatment of PID d. treatment of congenital anomalies ANS: C Pediatric surgery is a multidisciplinary field that encompasses many surgical specialties.

Most procedures can be classified into one of three groups: trauma surgery, treatment of disease, and treatment of congenital anomalies.

DIF:

2

REF: p. 908

2. During surgery, the prewarmed operating room (OR), warm air blanket, and overhead lighting contribute to . a. OR environment b. intraoperative procedure c. intraoperative warming d. all of the above ANS: C During surgery, the OR is prewarmed to maintain the core temperature.

DIF:

2

REF: p. 910

3. Infants and children can become rapidly dehydrated. Before surgery begins, a(n) line is inserted to maintain access to the circulatory system. a. IV b. endotracheal tube c. catheter d. tube ANS: A Infants and children can become rapidly dehydrated. Before surgery begins, an IV line is inserted to maintain access to the circulatory system.

DIF:

2

REF: p. 910

4. The causative agent of measles is a. Treponema pallidum b. varicella-zoster virus c. rubella virus

.

SOURCE: Browsegrades.net

d. herpesvirus ANS: C The causative agent of measles is rubella virus.

DIF:

2

REF: p. 911

5. The causative agent of cerebral calcifications, microcephaly, and heart defects is . a. Toxoplasma gondii b. varicella-zoster virus c. rubella virus d. herpesvirus ANS: A The causative agent of cerebral calcifications, microcephaly, and heart defects is Toxoplasma gondii.

DIF:

2

REF: p. 911

6. The causative agent of syphilis is a. Treponema pallidum b. varicella-zoster virus c. rubella virus d. herpesvirus

.

ANS: A The causative agent of syphNilU isRisSTIrN epG onTeB m. aC paOllM idum.

DIF:

2

REF: p. 911

7. The causative agent of chickenpox is a. Treponema pallidum b. varicella-zoster virus c. rubella virus d. herpesvirus

.

ANS: B The causative agent of chickenpox is varicella-zoster virus.

DIF:

2

REF: p. 911

8. The causative agent of hydrocephalus and deafness is a. cytomegalovirus b. varicella-zoster virus c. rubella virus d. herpesvirus

.

ANS: A The causative agent of hydrocephalus and deafness is cytomegalovirus.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 911

9. The causative agent of retinal defect, microcephaly, and microphthalmia is a. cytomegalovirus b. varicella-zoster virus c. rubella virus d. herpesvirus

.

ANS: D The causative agent of retinal defect, microcephaly, and microphthalmia is herpesvirus.

DIF:

2

REF: p. 911

10. The method of induction depends on all the following EXCEPT a. child’s age b. presence of a parent c. whether there is IV access d. sex of child

.

ANS: D The method of induction depends on the child’s age, whether there is IV access, the presence of a parent, preference and skill of the anesthesia care provider, and ASA classification.

DIF:

2

REF: p. 915

11. Pediatric medications are pN rescR ribeId aG ccorB di. ngCtoM the child’s U S N T O a. developmental stage b. age c. weight d. all of the above

.

ANS: C Pediatric medications are prescribed according to the child’s weight.

DIF:

2

REF: p. 915

12. Neonates and infants usually are transported to the OR in a a. small stretcher b. heated Isolette c. large crib d. parent’s arms

.

ANS: B Neonates and infants usually are transported to the OR in a heated Isolette.

DIF:

2

REF: p. 915

13. What size are pediatric instruments? a. Same as adults b. Micro instrument

SOURCE: Browsegrades.net

c. Smaller in dimension d. All of the above ANS: C The instruments themselves may be smaller in all dimensions, or only the tips may be smaller.

DIF:

2

REF: p. 916

MATCHING Match the congenital and genetic abnormalities with the definition. a. Anencephaly b. Atrial septal defect c. Branchial cleft cysts and clefts d. Chest wall deformities e. Choanal atresia f. Cleft lip or palate g. Coarctation of the aorta h. Esophageal atresia i. Gastroschisis j. Hirschsprung disease k. Infantile hypertrophic l. Omphalocele m. Patent ductus arteriosus n. Pulmonary valve stenosis N R I G B.C M U S N T O o. Spina bifida p. Syndactyly q. Tetralogy of Fallot r. Tracheoesophageal fistula s. Ventricular septal defect t. Wilms tumor 1. Congenital narrowing of the thoracic aorta that restricts blood flow to the lower body 2. A congenital anomaly that includes several types of neural tube defects, including incomplete closure of the bony spinal column around the spinal cord 3. Congenital anomaly in which large parts of the brain fail to develop 4. Is a congenital anomaly characterized by a stricture or blockage of the passage between the nasal sinus and the pharyngonasal airways 5. The most common primary renal malignancy of children 6. A combination of congenital defects 7. Congenital absence of ganglion cells, which control the relaxation and contraction that occur in peristalsis 8. These are embryonic remnants or slits in the neck region that persist as cysts or fistulas after birth 9. Webbing of the fingers or toes as a result of incomplete separation of the digits in embryonic life 10. Is a fetal heart structure that shunts blood from the right ventricle into systemic circulation 11. Congenital cardiac defect

SOURCE: Browsegrades.net

12. An abdominal wall defect in which the viscera form outside the body 13. Congenital cardiac defect in which a hole in the interatrial septum allows blood from the left atrium to flow into the right atrium 14. Complete or partial absence of the esophagus 15. Also called pyloric stenosis 16. Partial or complete division of the lip or palate prevents the infant from sucking effectively 17. A fistula connecting the esophagus with the trachea 18. Pectus excavatum or pectus carinatum 19. Congenital cardiac defect in which the pulmonary valve leaflets are fused, restricting circulation of the blood from the right ventricle to the lungs 20. A type of abdominal wall deformity in which the viscera develop outside the body, contained within a peritoneal sac 1. ANS: G 2. ANS: O 3. ANS: A 4. ANS: E 5. ANS: T 6. ANS: Q 7. ANS: J 8. ANS: C 9. ANS: P 10. ANS: M 11. ANS: S 12. ANS: I 13. ANS: B 14. ANS: H 15. ANS: K 16. ANS: F 17. ANS: R 18. ANS: D 19. ANS: N 20. ANS: L

DIF: 3 REF: p. 911 DIF: 3 REF: p. 912 DIF: 3 REF: p. 911 DIF: 3 REF: p. 911 DIF: 3 REF: p. 912 DIF: 3 REF: p. 912 DIF: 3 REF: p. 912 DIF: 3 REF: p. 911 DIF: 3 REF: p. 912 DIF: 3 REF: p. 912 DIF: 3 REF: p. 912 N R I G B. DIF: U3 S N T RC EO F:M p. 912 DIF: 3 REF: p. 911 DIF: 3 REF: p. 911 DIF: 3 REF: p. 912 DIF: 3 REF: p. 911 DIF: 3 REF: p. 912 DIF: 3 REF: p. 911 DIF: 3 REF: p. 912 DIF: 3 REF: p. 912

SOURCE: Browsegrades.net

Chapter 35: Neurosurgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. The neuron is the a. soma b. axon c. dendrites d. cell

type of the nervous system located throughout the body.

ANS: D The neuron is the cell type of the nervous system located throughout the body.

DIF:

2

REF: p. 938

2. The acts as the sending and receiving area for nerve impulses and is the energy center of the cell. a. soma b. axon c. dendrites d. cell ANS: A The soma acts as the sending and receiving area for nerve impulses and is the energy center of the cell.

DIF:

2

REF: p. 938

3. The carry/carries nerve impulses toward the cell. a. soma b. axon c. dendrites d. cell ANS: C The dendrites carry nerve impulses toward the cell.

DIF:

2

4. The a. soma b. axon c. dendrites d. cell

REF: p. 938 carry/carries nerve impulses away from the cell.

ANS: B The axon carries nerve impulses away from the cell.

DIF:

2

REF: p. 938

SOURCE: Browsegrades.net

5. Two bones are on either side of the skull, which contribute to the structure for the sides of the cranium. a. frontal b. temporal c. occipital d. parietal ANS: B Two temporal bones are on either side of the skull, which contribute to the structure for the sides of the cranium.

DIF:

2

REF: p. 938

6. One bone provides structure for the forehead and orbits. a. frontal b. temporal c. occipital d. parietal ANS: A One frontal bone provides structure for the forehead and orbits.

DIF:

2

REF: p. 938

7. One bone provides structure to the back of the skull and a portion of the floor of the cranium. a. frontal b. temporal c. occipital d. parietal ANS: C One occipital bone provides structure to the back of the skull and a portion of the floor of the cranium.

DIF:

2

8. Two the cranium. a. frontal b. temporal c. occipital d. parietal

REF: p. 938 bones on either side of the skull provide structure for the sides and roof of

ANS: D Two parietal bones on either side of the skull provide structure for the sides and roof of the cranium.

DIF:

2

REF: p. 938

SOURCE: Browsegrades.net

9. The pericranium is the periosteal layer of the skull bones. It is covered with all of the following EXCEPT . a. muscle b. galea c. dura d. skin ANS: C The pericranium is the periosteal layer of the skull bones. It is covered by muscle and the galea, a tough, fibrous tissue sheet. The skin of the scalp is very thick and highly vascular and contains numerous hair follicles.

DIF:

2

REF: p. 938

10. The brain is divided into three main sections, including all of the following EXCEPT . a. cerebrum b. pericranium c. cerebellum d. brainstem ANS: B The brain is divided into three main sections: the cerebrum, cerebellum, and brainstem.

DIF:

2

REF: p. 938

11. The is also knownNas R the I foreG braB in. . C M U S N T O a. cerebrum b. cerebellum c. brainstem d. pericranium ANS: A The cerebrum is also known as the forebrain.

DIF:

2

REF: p. 938

12. The is also known as the hindbrain. a. cerebrum b. cerebellum c. brainstem d. pericranium ANS: B The cerebellum is also known as the hindbrain.

DIF:

2

REF: p. 940

13. The major structures of the midbrain include all of the following EXCEPT a. thyroid gland b. hypothalamus

SOURCE: Browsegrades.net

.

c. thalamus d. pituitary gland ANS: A The major structures of the midbrain are the thalamus, hypothalamus, posterior pituitary gland, and pineal gland.

DIF:

2

14. There are a. 12 b. 5 c. 1 d. 7

REF: p. 941 cervical vertebrae.

ANS: D There are 7 cervical vertebrae.

DIF:

2

15. There are a. 12 b. 5 c. 1 d. 7

REF: p. 942 lumbar vertebrae.

ANS: B There are 5 lumbar vertebrN aeU . RSINGTB.COM DIF:

2

16. There are a. 12 b. 5 c. 1 d. 7

REF: p. 942 sacral vertebrae.

ANS: B There are 5 sacral vertebrae.

DIF:

2

17. There are a. 12 b. 5 c. 1 d. 7

REF: p. 942 thoracic vertebrae.

ANS: A There are 12 thoracic vertebrae.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 942

18. The nerves that originate in the brain are responsible for the sensory and motor functions of the body. a. spinal b. cranial c. peripheral d. thoracic ANS: B The cranial nerves are 12 pairs of nerves that originate in the brain and are responsible for the sensory and motor functions of the body.

DIF: 19.

2

REF: p. 943

nerves are composed of small bundles of nerve fibers, called fascicles, which are surrounded by a sheath called the endoneurium. a. Spinal b. Cranial c. Peripheral d. Thoracic ANS: C Peripheral nerves are composed of small bundles of nerve fibers, called fascicles, which are surrounded by a sheath called the endoneurium.

DIF:

2

G B.C M U S N T O

REFN : pR . 94I 4

20. The nerves occur in pairs and originate from the spinal cord near their corresponding vertebra. a. spinal b. cranial c. peripheral d. thoracic ANS: A The spinal nerves occur in pairs and originate from the spinal cord near their corresponding vertebra.

DIF:

2

REF: p. 943

21. Small, square, felt sponges made of cotton or rayon to control bleeding on neural and vascular tissue are referred to as . a. 4  4s b. laps c. Kittners d. cottonoids ANS: D Small, square, felt sponges made of cotton or rayon to control bleeding on neural and vascular tissue are commonly referred to as patties or cottonoids.

SOURCE: Browsegrades.net

DIF:

2

REF: p. 950

22. What type of dressing would be placed on a spinal incision? a. Radiopaque sponge b. Tegaderm c. ABD pads d. Telfa ANS: D Spinal incisions are dressed with non-adherent Telfa and absorbent gauze pads secured with tape.

DIF:

2

REF: p. 950

23. Gardner-Wells tongs may be used to secure a. patient’s arms b. patient’s head c. patient’s spine d. patient’s legs

.

ANS: B Gardner-Wells tongs may be used to secure the patient’s head in a particular position and as a means for attaching traction devices.

DIF:

2

REF: p. 952

N R I G B.C M

24. All of the following are patieU nt pS ositN ion T devicesOEXCEPT a. headrest b. Telfa c. Operating room (OR) table d. Wilson frame

.

ANS: B Headrest, OR table, and Wilson frame are all used for patient position.

DIF:

2

REF: p. 950 | p. 952

25. During a craniotomy, the patient is positioned using a a. round b. oval c. horseshoe d. oblong

headrest or pin fixation.

ANS: C During a craniotomy, the patient is positioned using a horseshoe headrest or pin fixation.

DIF:

2

REF: p. 952

26. What type of ESU is used during a craniotomy? a. Monopolar

SOURCE: Browsegrades.net

b. Harmonic c. Needle d. Bipolar ANS: D A bipolar ESU is used to open the pia.

DIF:

2

REF: p. 953

27. During a microdiscectomy, what type of retractor is used? a. Weitlaner b. Ragnell c. Senns d. Tubular ANS: D A tubular retractor is placed, and the dilating tubes are removed.

DIF:

2

REF: p. 977

28. During a microdiscectomy, the wound edges are approximated with a. Steri-Strips. b. Dermabond. c. suture. d. A and B.

.

ANS: D The wound edges are approNxU imRaS teI dN wG ithTSBte.riC -SOtrM ips or Dermabond glue.

DIF:

2

REF: p. 977

29. During a microdiscectomy, Gelfoam pledgets are soaked in a. lidocaine. b. topical thrombin. c. saline. d. none of the above.

ANS: B Gelfoam pledgets are soaked in topical thrombin.

DIF:

2

REF: p. 977

MATCHING Match the cranial nerves with the definition. a. I (olfactory) b. II (optic) c. III (oculomotor) d. IV (trochlear) e. V (trigeminal)

SOURCE: Browsegrades.net

.

f. g. h. i. j. k. l.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

VI (abducens) VII (facial) VIII (vestibulocochlear) IX (glossopharyngeal) X (vagus) XI (accessory) XII (hypoglossal)

Controls lateral movement of the eye Innervates the muscle of the tongue Responsible for the sense of smell Innervates the pharyngeal and laryngeal muscles, heart, pancreas, lungs, and digestive systems Controls the oblique muscle of the eye Controls the sense of taste Has two parts, a cranial portion and a spinal portion Conveys impulses for sight A motor nerve that controls the muscle in the face and scalp Controls muscle that moves the eye and iris A sensory nerve that controls the sensation of the face, forehead, mouth, nose, and top of head Controls hearing and equilibrium

1. ANS: F 2. ANS: L 3. ANS: A 4. ANS: J 5. ANS: D 6. ANS: I 7. ANS: K 8. ANS: B 9. ANS: G 10. ANS: C 11. ANS: E 12. ANS: H

DIF: 3 REF: p. 943 DIF: 3 REF: p. 943 DIF:NU3RSINGTB.RC EO F:M p. 943 DIF: 3 REF: p. 943 DIF: 3 REF: p. 943 DIF: 3 REF: p. 943 DIF: 3 REF: p. 943 DIF: 3 REF: p. 943 DIF: 3 REF: p. 943 DIF: 3 REF: p. 943 DIF: 3 REF: p. 943 DIF: 3 REF: p. 943

SOURCE: Browsegrades.net

Chapter 36: Emergency Trauma Surgery Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1.

is/are the leading cause(s) of death between the ages of 1 and 45 and the third leading cause of death in all age groups. a. Motorcycle accidents b. Motor vehicle accidents c. Boating accidents d. Trauma ANS: D Trauma is the leading cause of death between the ages of 1 and 45 and the third leading cause of death in all age groups.

DIF:

2

REF: p. 983

2. During a true surgical emergency, more so than in any other scenario, to a successful outcome for the patient. a. teamwork b. preparation c. counting d. instruments

is key

ANS: A During a true surgical emergency, more so than in any other scenario, teamwork is key to a successful outcome for the patient.

DIF:

2

REF: p. 984

3. Although the ability to respond quickly to the demand of surgery is important, so is . a. teamwork b. accuracy c. preparation d. instruments ANS: B Accuracy in emergency terms means “getting it right the first time.”

DIF:

2

4. Clear a. teamwork b. accuracy c. preparation d. communication

REF: p. 984 is the pivot point of team efforts in an emergency.

ANS: D

SOURCE: Browsegrades.net

Clear communication is the pivot point of team efforts in an emergency. There may be many people attending the patient at one time during the emergency.

DIF:

2

REF: p. 984

5. ATLS is . a. Advanced Trauma Life System b. Advanced Trauma Limited Support c. Advanced Trauma Life Support d. Advanced Trauma Limited System ANS: C ATLS is a program established by the American College of Surgeons for protocols and training in trauma medicine.

DIF: 6. a. b. c. d.

2

REF: p. 985

is/are treatment pathways in trauma surgery.

Signs and symptoms Algorithms Hemorrhagic shock None of the above

ANS: B Algorithms are treatment pathways in trauma surgery that usually guide the surgeon and other attending consultants toward a course of action.

DIF:

2

N R I G B.COM

REF: Up. 9S85N T

7. Subnormal core body temperature for an extended period of time is known as a. metabolic acidosis b. coagulopathy c. hypothermia d. hyperthermia

.

ANS: C Subnormal core body temperature for an extended period of time is known as hypothermia.

DIF:

2

REF: p. 986

8. Lower-than-normal blood pH is what condition? a. Metabolic acidosis b. Coagulopathy c. Hypothermia d. Hyperthermia ANS: A Lower-than-normal blood pH is metabolic acidosis.

DIF:

2

REF: p. 986

SOURCE: Browsegrades.net

9.

, a vascular failure caused by prolonged, severe blood loss, is the most common cause of mortality in trauma. a. Hypothermia b. Coagulopathy c. Hemorrhagic shock d. Metabolic acidosis ANS: C A vascular failure, caused by prolonged, severe blood loss, is the most common cause of mortality in trauma and is called hemorrhagic shock.

DIF:

2

REF: p. 986

10. The compensatory mechanisms in acute injury can lead to the condition called a. compartment syndrome b. metabolic acidosis c. hemorrhagic shock d. hypothermia ANS: A The compensatory mechanisms in acute injury can lead to compartment syndrome.

Compartment syndrome is tissue swelling within a closed area such as muscle bundles or the abdomen.

DIF: 11. a. b. c. d.

2

REF: p. 987

is the proceN ss oR f reI storG ing B ph.yC siolM ogical balance in injury.

U S N T O Metabolic acidosis Hypothermia Hyperthermia Resuscitation

ANS: D Resuscitation is the process of restoring physiological balance in injury. In the context of trauma, resuscitation refers to restoration from hemorrhagic shock, including establishment of normal circulation blood volume, tissue perfusion, and vascular tone.

DIF:

2

REF: p. 988

12. The secondary survey is also known as a. occult injury b. hospital care c. clinical care d. emergency care

.

ANS: B The secondary survey, also known as hospital care, is performed once the patient is stable enough to move.

DIF:

2

REF: p. 988

SOURCE: Browsegrades.net

.

13. Consent for invasive procedures, including emergency surgery, is obtained from the patient if he or she is able, or from , according to hospital policy. a. another person b. responsible individuals c. the parents d. none of the above ANS: B Consent for invasive procedures, including emergency surgery, is obtained from the patient if he or she is able, or from responsible individuals, according to hospital policy.

DIF:

2

REF: p. 988-989

14. Death from is the second leading cause of mortality in the United States, and approximately 115,000 cases of injury are treated each year. a. firearms; firearm b. stabbing; stabbing c. trauma; trauma d. motor vehicle accident; motor vehicle accident ANS: A Death from firearms is the second leading cause of mortality in the United States.

Approximately 115,000 cases of firearm injury are treated each year. The most common firearm used in personal violence is the handgun.

DIF:

2

REF: p. 989

N R I G B.C M

15. When passing any instrumenU t thaSt wN ill cT ome in O contact with a bullet, fragments, shrapnel, or other ballistic item, ensure that the of the instrument are protected with rubber shod or completely covered with a sponge. a. finger hold b. ratchets c. serrations d. tips ANS: D When passing any instrument that will come in contact with a bullet, fragments, shrapnel, or other ballistic item, ensure that the tips of the instrument are protected with rubber shod or completely covered with a sponge. Markings on the fragment or bullet may not be visible without magnification but are nevertheless present on all weapons.

DIF:

2

REF: p. 989

16. One goal of damage control surgery is to focus solely on lifesaving maneuvers, including all of the following EXCEPT . a. control of feeding b. control of hemorrhage c. control of fecal spillage d. relief of compartment syndrome ANS: A

SOURCE: Browsegrades.net

One goal of damage control surgery is to focus solely on lifesaving maneuvers: control of hemorrhage, control of fecal spillage, relief of compartment syndrome, packing a body cavity, delayed or phased closure of the wound, and splinting or external fixation to prevent extension of injuries.

DIF:

2

REF: p. 989

17. If the patient is stabilized in 12 to 48 hours, he or she can then be returned to surgery for a procedure. a. follow-up b. emergency c. schedule d. definitive ANS: D If the patient is stabilized in 12 to 48 hours, he or she can then be returned to surgery for a definitive procedure.

DIF:

2

REF: p. 989

18. Hospitals should have basic setups for a. craniotomy b. bowel resection c. replantation d. vasovasostomy

_.

ANS: A All health care facilities surgical departments prepare emergency case carts in preparation for specific emergencies likely to arrive for treatment. These include basic setups for craniotomy, caesarean section, and abdominal aneurysm.

DIF:

1

REF: p. 989

19. To avoid having instrument sets opened but not used, specialty instruments can be placed on a the operating room (OR) in the sterile core. a. cart inside b. cart outside c. sterile uncovered Mayo stand in d. sterile covered Mayo stand in ANS: B To avoid having instrument sets opened but not used, specialty instruments can be placed on a cart outside the OR in the sterile core.

DIF:

1

20. Copious amounts of a. drug b. irrigation c. heparin

REF: p. 990 solution are often needed during trauma surgery.

SOURCE: Browsegrades.net

d. coagulation ANS: B Copious amounts of irrigation solution are often needed during trauma surgery. These are used to flush and clean the wound of tissue debris and foreign objects.

DIF: 21.

1

REF: p. 990

-based tissue sealants are used only if there is no coagulopathy present because these depend on an intact coagulation response. a. Thrombin b. Lidocaine c. Heparin d. Warfarin ANS: A Thrombin-based tissue sealants are used only if there is no coagulopathy present because these depend on an intact coagulation response.

DIF:

1

REF: p. 990

22. Postoperative serosanguinous pooling is controlled with wound a. drains b. dressings c. clamps d. pins

.

ANS: A Postoperative serosanguinous pooling is controlled with wound drains, whereas fluid and electrolyte imbalance is managed through systemic resuscitative measures.

DIF:

1

REF: p. 990

23. The real potential for extending the patient’s injuries exists during . a. positioning; skin prep b. moving; handling c. induction; wake up d. preoperative preparations; postoperative preparation

and

ANS: B Positioning the trauma patient requires precise coordination among members of the surgical team. The real potential for extending the patient’s injuries exists during moving and handling.

DIF:

1

REF: p. 991

24. Normothermia is maintaining core body temperature a. at the absolute minimum that supports life. b. as close to normal as possible. c. as close to maximum as possible.

SOURCE: Browsegrades.net

.

d. at 25 degrees Celsius.

ANS: B Maintaining the patient’s core temperature as close to normal as possible is a major goal of emergency treatment.

DIF:

1

REF: p. 991

25. You are called in on a motor vehicle accident; the patient is disoriented and scared. As a health care professional, it is important to provide some measure of _ for the patient. a. emotional comfort b. distress relief c. safety education d. standard precaution ANS: A In a severe emergency, all activity is focused on lifesaving; however, whenever possible, it is important to provide some measure of emotional comfort.

DIF:

1

REF: p. 991

26. You are scrubbed in on an emergency case when the circulator tells you that all standardized procedures may be suspended in life-threatening situations. a. surgical b. count c. aseptic d. anesthetic ANS: B In emergency circumstances some of the usual routines are abbreviated. This includes sponge and instrument counts. Although this is not an ideal situation, the American College of Surgeons has stated that standardized counting procedures may be suspended in life-threatening situations.

DIF:

1

REF: p. 992

27. The term “up” means what during an emergency case? a. Items are sterile and ready for use b. On the Mayo ready for use c. The patient’s blood pressure is too high d. The patient’s heart rate is too high ANS: B A general rule that most surgical technologists follow when setting up for an emergency is to prepare items for their immediate use of the field. The term “up” means “up on the Mayo, ready to use.”

DIF:

1

REF: p. 992

MATCHING

SOURCE: Browsegrades.net

Match the terms with the definitions. Not all answers will be used. a. Blunt injury b. Cardiac rupture c. Cardiac tamponade d. Coagulopathy e. Compartment syndrome f. Contusion g. Damage control surgery h. Definitive diagnosis i. Definitive procedure j. Exsanguinating k. Flail chest l. FAST m. Hemorrhagic shock n. Hemothorax o. Metabolic acidosis p. Occult injury q. Penetrating injury r. Pneumothorax 1. Pressure on the heart causing restriction and damage to the conduction system 2. Injury that results in air in the pleural space causing displacement or collapse of the respiratory structures 3. Bruising 4. Trauma that results in deep tissue injury without rupture of the skin 5. A protocol of ATLS in whiN chUuRltS raI soNuG ndTiB s. usC edOiM n a focus area to diagnose severe trauma 6. Condition in which the body’s normal blood clotting mechanism ceases to function; characteristic in severe multitrauma 7. Tearing of the atria or ventricles as a result of trauma 8. Evidence-based diagnosis of a medical problem using normal investigative procedures, such as imaging studies 9. A type of shock characterized by vascular failure resulting from severe bleeding 10. Hemorrhage with the potential to deplete the patient’s total blood volume 11. Surgery whose objective is to stop hemorrhage and prevent sepsis without attempting reconstruction or anatomical continuity 12. Increased pressure in any compartment of the body 13. A planned surgical procedure, usually with specific objectives for reconstruction or restoring continuity of anatomical structures 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS:

C R F A L D B H

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3 3 3 3

REF: REF: REF: REF: REF: REF: REF: REF:

p. 983 p. 983 p. 983 p. 983 p. 983 p. 983 p. 983 p. 983

SOURCE: Browsegrades.net

9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS:

M J G E I

DIF: DIF: DIF: DIF: DIF:

3 3 3 3 3

REF: REF: REF: REF: REF:

p. 983 p. 983 p. 983 p. 983 p. 983

SOURCE: Browsegrades.net

Chapter 37: Disaster Preparedness and Response Fuller: Surgical Technology: Principles and Practice, 7th Edition MULTIPLE CHOICE 1. a. b. c. d.

is a catastrophic event that poses a large-scale risk to human life and property.

Tornado Disaster Hurricane Earthquake

ANS: B Disaster is a catastrophic event that poses a large-scale risk to human life and property.

DIF: 2.

2

REF: p. 1010

is a localized emergency, such as a transportation accident, explosion, or structural collapse, in which the number of victims overwhelms local health care services. a. An emergency b. A national incident c. A mass casualty event d. None of the above ANS: C A mass casualty event is a localized emergency, such as a transportation accident, explosion, or structural colN lapsR e, inIwhGichB th.eC num Mber of victims overwhelms local health care services.

DIF:

3.

2

U S N T

O

REF: p. 1010

or disasters are unintentional events caused by human activity, compounded by error or negligence. a. War, technology b. Technology, chemical c. Chemical, war d. Technological, industrial ANS: D Technological or industrial disasters are unintentional events caused by human activity, compounded by error or negligence.

DIF:

2

REF: p. 1013

4. Large-scale can occur where flammable materials are used in manufacturing or in large storage facilities, including oil refineries, chemical plants, and manufacturing facilities. a. Hazardous material accident b. Radiation accident c. Explosions

SOURCE: Browsegrades.net

d. Transportation accident ANS: C Large-scale explosions can occur where flammable materials are used in manufacturing or in large storage facilities, including oil refineries, chemical plants, and manufacturing facilities.

DIF: 5.

2

REF: p. 1013

occur in similar conditions as explosions, with greater risk in refineries and other locations where large amounts of hazardous materials are stored or manufactured. a. Hazardous material accidents b. Radiation accidents c. Explosions d. Transportation accidents ANS: A Hazardous material accidents occur in similar conditions as explosions, with greater risk in refineries and other locations where large amounts of hazardous materials are stored or manufactured.

DIF:

6.

2

REF: p. 1013

such as the Fukushima nuclear crisis and Chernobyl are uncommon but devastating to families and communities. a. Hazardous material accN idenRts I G B.C M U S N T O b. Radiation accidents c. Explosions d. Transportation accidents ANS: B Radiation accidents such as the Fukushima nuclear crisis and Chernobyl are uncommon but devastating to families and communities.

DIF:

7.

2

REF: p. 1013

are large-scale aviation, vehicle, and train accidents, which often result in mass casualty events. a. Hazardous material accidents b. Radiation accidents c. Explosions d. Transportation accidents ANS: D Transportation accidents are large-scale aviation, vehicle, and train accidents, which often result in mass casualty events.

DIF:

8.

2

REF: p. 1013 is/are a wide-scale, rapidly contagious infectious disease.

SOURCE: Browsegrades.net

a. b. c. d.

Acts of terrorism Bioterrorism Chemical terrorism A pandemic

ANS: D A pandemic is a wide-scale, rapidly contagious infectious disease.

DIF:

2

REF: p. 1013

9. What is the intentional release of harmful biological agents into the environment? a. Acts of terrorism b. Bioterrorism c. Chemical terrorism d. Pandemic ANS: B Bioterrorism is the intentional release of harmful biological agents into the environment.

DIF:

2

REF: p. 1014

10. What is the use of chemical agents for intentional harm in the population? a. Acts of terrorism b. Bioterrorism c. Chemical terrorism d. Pandemic ANS: C Chemical terrorism is the use of chemical agents for intentional harm in the population.

DIF:

2

REF: p. 1014

11. A(n) is a more geographically isolated event that can be handled by local services. a. emergency b. mass casualty event c. disaster d. medical facility evacuation ANS: A An emergency is more geographically isolated event that can be handled by local emergency services, such as ambulances, the fire department, or paramedics.

DIF:

2

REF: p. 1010

12. A level disaster is classified by statewide and federal assistance being required because the effects of the disaster have overwhelmed local and regional resources. a. I b. II c. III d. IV

SOURCE: Browsegrades.net

ANS: C Level III; statewide and federal assistance are required because the effects of the disaster have overwhelmed local and regional resources.

DIF: 13.

2

REF: p. 1010

, or risk reduction, is a process or activity that minimizes the impact of an event. a. Response b. Coordination c. Mitigation d. Logistics and supply chains ANS: C Mitigation, or risk reduction, is a process or activity that minimizes the impact of an event.

DIF:

14.

2

REF: p. 1018

is a process in which casualties are given emergency medical treatment according to the probability of their survival. a. Triage b. Local incidence command system c. Recovery d. Morgue ANS: A Triage is a process in whichNcUaR suS alI tiN esGaT reBg. ivC enOeM mergency medical treatment according to the probability of their survival.

DIF:

15.

1

REF: p. 1022

are those with a particularly high risk for injury or harm as a result of a disaster. a. US Navy Seals b. FEMA workers c. American Red Cross workers d. Vulnerable populations ANS: D Vulnerable populations are those with a particularly high risk for injury or harm as a result of a disaster.

DIF:

1

REF: p. 1020

MATCHING Match each term with the correct definition. a. AHRQ b. CDC

SOURCE: Browsegrades.net

c. DHHS d. DHS e. DHSES f. DMAT g. EMA h. EOC i. FCC j. FEMA k. HazMat l. HICS m. HRSA n. MCE o. NDMS p. NIMS q. NRF r. NWS s. START t. WHO 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Emergency operations center National Weather Service Mass casualty event Hazardous materials National Incident Management System Emergency management agency Department of Homeland Security NURSIN GTB.COM Centers for Disease Control and Prevention Department of Health and Human Services Division of Homeland Security and Emergency Services Disaster Medical Assistance Team World Health Organization Health Resources and Services Administration Hospital incident command system Simple triage and rapid treatment Federal Communications Commission National Response Framework Federal Emergency Management Agency National Disaster Medical System Agency for Healthcare Research and Quality

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS:

H R N K P G A

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF:

p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009

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8. ANS: 9. ANS: 10. ANS: 11. ANS: 12. ANS: 13. ANS: 14. ANS: 15. ANS: 16. ANS: 17. ANS: 18. ANS: 19. ANS: 20. ANS:

B C E F T M L S I Q J O A

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

2 2 2 2 2 2 2 2 2 2 2 2 2

REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF: REF:

p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009 p. 1009

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